Department of Neurosurgery, Center for Neurosciences and Spine, Virginia Mason Franciscan Health, Seattle, WA.
Spine (Phila Pa 1976). 2024 Aug 15;49(16):E250-E261. doi: 10.1097/BRS.0000000000005055. Epub 2024 May 29.
This study is a systematic review.
This systematic review aims to synthesize existing studies and highlight the significance of ergonomic considerations for spine surgeons' well-being and the impact on patient outcomes.
Spine surgery is a physically demanding field that poses several risks to surgeons, particularly with musculoskeletal disorders. Despite the well-documented consequences of musculoskeletal injuries endured by surgeons, surgical ergonomics in spine surgery has received limited attention.
Following PRISMA guidelines, a comprehensive literature search was conducted in PubMed and Embase. Studies focusing on surgeon ergonomics in spine surgery were selected. Data extracted included study details, surgeon demographics, ergonomic factors, and outcomes. Qualitative analysis was performed due to the heterogeneous nature of study designs and criteria.
Eleven studies met the inclusion criteria. Six studies utilized surveys to explore physical challenges, prevalence rates of pain, work practices, and ergonomic tools. Two studies employed optoelectronic motion analysis to assess the spinal angles of the surgeon during surgery. Two studies assesed ergonomics in different visualization methods using rapid entire body assessment (REBA). One study applied video analysis to scrutinize surgeons' neck postures during the case. The results demonstrated a varying prevalence and diverse presentations of musculoskeletal disorders, varying impact on surgical performance, and nuanced relationships between experience, workload, and ergonomic concerns.
This systematic review summarizes the heterogeneous evaluations of ergonomics in spine surgery. Overall, upwards of three-quarters of spine surgeons have reported musculoskeletal discomfort, most commonly presented as back pain, neck pain, and hand/wrist discomfort. These symptoms are often exacerbated by the use of loupes, operating bed height, and extended periods of time in various positions. Studies demonstrate that physical discomfort is associated with the surgeons' mental and emotional well-being, leading to stress, burnout, and reduced job satisfaction, all of which impact patient care.
本研究为系统综述。
本系统综述旨在综合现有研究，强调人体工程学考虑因素对脊柱外科医生健康的重要性及其对患者结局的影响。
脊柱手术是一项体力要求很高的领域，会给外科医生带来多种风险，尤其是肌肉骨骼疾病。尽管有大量文献记载了外科医生所遭受的肌肉骨骼损伤的后果，但脊柱手术中的手术人体工程学仍未得到充分关注。
根据 PRISMA 指南，在 PubMed 和 Embase 中进行了全面的文献检索。选择了关注脊柱手术中外科医生人体工程学的研究。提取的数据包括研究细节、外科医生人口统计学、人体工程学因素和结局。由于研究设计和标准存在异质性，因此进行了定性分析。
符合纳入标准的研究有 11 项。其中 6 项研究采用问卷调查的方式探讨了物理挑战、疼痛发生率、工作实践和人体工程学工具。2 项研究采用光电运动分析来评估手术中外科医生的脊柱角度。2 项研究采用快速全身评估（REBA）评估不同可视化方法中的人体工程学。1 项研究应用视频分析来仔细观察手术中外科医生的颈部姿势。结果表明，肌肉骨骼疾病的发生率和表现形式多种多样，对手术表现的影响也各不相同，经验、工作量和人体工程学问题之间存在复杂的关系。
本系统综述总结了脊柱手术中人体工程学的异质性评估。总体而言，超过四分之三的脊柱外科医生报告有肌肉骨骼不适，最常见的表现是背痛、颈痛和手/腕部不适。这些症状通常因使用手术放大镜、手术床高度以及长时间处于各种姿势而加重。研究表明，身体不适与外科医生的精神和情绪健康有关，导致压力、倦怠和工作满意度降低，所有这些都会影响患者的护理。
