Prevalence and risk factors of neck pain in spine surgeons - Are we our own patients?

Acharya, Hriday; Patel, Priyank Pravin; Shetty, Gautam M.; Shah, Munjal; Bamb, Harshal; Nene, Abhay

doi:10.1016/j.jcot.2022.102012

Cited by 7 publications

(16 citation statements)

References 27 publications

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“…Included articles were published between 1995 and 2022. Of the 42 articles, 24 were included in our quantitative synthesis of work-related musculoskeletal disorders [3, 5-13, 15, 17, 23, 24, 27, 42, 49, 52-54, 67, 68, 72, 76] and 18 were included in our descriptive synthesis of orthopaedic ergonomics [14, 26, 29-31, 34, 38, 43-45, 48, 50, 58-60, 64, 65, 73]. No articles assessed both work-related musculoskeletal disorders and surgical ergonomics.…”

Section: Methodsmentioning

confidence: 99%

“…The mean age of the 2083 orthopaedic surgeons in studies that reported a mean age was 48 years, and 79% (3210 of 4062) of orthopaedic surgeons whose gender was recorded were men. Eleven studies used a de novo questionnaire [3, 10, 23, 24, 27, 49, 52-54, 72, 76]. Nine studies used the Physical Discomfort Survey [5, 7-9, 11-13, 42, 67].…”

Section: Methodsmentioning

confidence: 99%

“…Eighteen studies captured work-related musculoskeletal disorders across the entire body and reported the overall prevalence of orthopaedic surgeons experiencing one or more work-related musculoskeletal disorders [3, 5-12, 15, 17, 23, 24, 27, 52, 53, 67, 68]. By anatomic location, work-related musculoskeletal disorders were reported in the back in 21 studies [5-13, 15, 17, 23, 24, 42, 49, 53, 54, 67, 68, 72, 76]; the head or neck in 19 studies [3, 5-7, 9, 11-13, 15, 17, 23, 24, 42, 49, 53, 54, 67, 68, 76]; the forearm, wrist, or hand in 19 studies [3, 5-13, 15, 17, 23, 42, 53, 54, 67, 68, 72]; the elbow in 10 studies [6-9, 11, 12, 15, 23, 67, 68]; the knee or lower leg in 14 studies [5-9, 11-13, 15, 17, 23, 42, 67, 68]; the shoulder in 13 studies [6-9, 11, 12, 15, 23, 24, 53, 54, 67, 68]; the foot or ankle in 13 studies [5-9, 11, 12, 15, 23, 42, 53, 67, 68]; and the hip or thigh in 11 studies [5-7, 9, 11, 12, 15, 23, 42, 67, 68]. The treatment prevalence of work-related musculoskeletal disorders was reported in 11 studies [3, 5, 7, 10, 11, 15, 24, 27, 52, 53, 67].…”

Section: Methodsmentioning

confidence: 99%

“…By anatomic location, work-related musculoskeletal disorders were reported in the back in 21 studies [5-13, 15, 17, 23, 24, 42, 49, 53, 54, 67, 68, 72, 76]; the head or neck in 19 studies [3, 5-7, 9, 11-13, 15, 17, 23, 24, 42, 49, 53, 54, 67, 68, 76]; the forearm, wrist, or hand in 19 studies [3, 5-13, 15, 17, 23, 42, 53, 54, 67, 68, 72]; the elbow in 10 studies [6-9, 11, 12, 15, 23, 67, 68]; the knee or lower leg in 14 studies [5-9, 11-13, 15, 17, 23, 42, 67, 68]; the shoulder in 13 studies [6-9, 11, 12, 15, 23, 24, 53, 54, 67, 68]; the foot or ankle in 13 studies [5-9, 11, 12, 15, 23, 42, 53, 67, 68]; and the hip or thigh in 11 studies [5-7, 9, 11, 12, 15, 23, 42, 67, 68]. The treatment prevalence of work-related musculoskeletal disorders was reported in 11 studies [3, 5, 7, 10, 11, 15, 24, 27, 52, 53, 67]. A measure of work-related musculoskeletal disorders leading to disability was reported in 10 studies [5, 7-9, 11, 12, 15, 23, 24, 67].…”

Section: Methodsmentioning

confidence: 99%

“…(2) What is the treatment prevalence associated with work-related musculoskeletal disorders in orthopaedic surgeons? (3) What is the disability burden of work-related musculoskeletal disorders in orthopaedic surgeons? (4) What is the scope of orthopaedic surgical ergonomic assessments and interventions?…”

Section: Introductionmentioning

confidence: 99%

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High Prevalence of Work-related Musculoskeletal Disorders and Limited Evidence-based Ergonomics in Orthopaedic Surgery: A Systematic Review

Vasireddi,

Shah

et al. 2023

Clin Orthop Relat Res

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Background The Centers for Disease Control defines work-related musculoskeletal disorders as disorders of the nerves, muscles, tendons, joints, spinal discs, and cartilage that are caused or exacerbated by the environment or nature of work. Previous meta-analyses have characterized work-related musculoskeletal disorders among interventionists, general surgeons, and other surgical subspecialties, but prevalence estimates, prognosis, and ergonomic considerations vary by study and surgical specialty. Questions/purposes (1) What is the career prevalence of work-related musculoskeletal disorders in orthopaedic surgeons? (2) What is the treatment prevalence associated with work-related musculoskeletal disorders in orthopaedic surgeons? (3) What is the disability burden of work-related musculoskeletal disorders in orthopaedic surgeons? (4) What is the scope of orthopaedic surgical ergonomic assessments and interventions? Methods A systematic review of English-language studies from PubMed, MEDLINE, Embase, and Scopus was performed in December 2022 and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies that presented prevalence estimates of work-related musculoskeletal disorders or assessed surgical ergonomics in orthopaedic surgery were included. Reviews, case reports, gray literature (conference abstracts and preprints), and studies with mixed-surgeon (nonorthopaedic) populations were excluded. The search yielded 5603 abstracts; 24 survey-based studies with 4876 orthopaedic surgeons (mean age 48 years; 79% of surgeons were men) were included for an analysis of work-related musculoskeletal disorders, and 18 articles were included for a descriptive synthesis of ergonomic assessment. Quality assessment using the Joanna Briggs Institute Tool revealed that studies had a low to moderate risk of bias, largely because of self-reporting survey-based methodology. Because of considerable heterogeneity and risk of bias, prevalence outcomes were not pooled and instead are presented as ranges (mean I2 = 91.3%). Results The career prevalence of work-related musculoskeletal disorders in orthopaedic surgeons ranged from 37% to 97%. By anatomic location, the prevalence of work-related musculoskeletal disorders in the head and neck ranged from 4% to 74%; back ranged from 9% to 77%; forearm, wrist, and hand ranged from 12% to 54%; elbow ranged from 3% to 28%; shoulder ranged from 3% to 34%; hip and thigh ranged from 1% to 10%; knee and lower leg ranged from 1% to 31%; and foot and ankle ranged from 4% to 25%. Of orthopaedic surgeons reporting work-related musculoskeletal disorders, 9% to 33% had a leave of absence, practice restriction or modification, or early retirement, and 27% to 83% received some form of treatment. Orthopaedic surgeons experienced biomechanical, cardiovascular, neuromuscular, and metabolic stress during procedures. Interventions to improve orthopaedic surgical ergonomics have been limited, but have included robotic assistance, proper visualization aids, appropriate use of power tools, and safely minimizing lead apron use. In hip and knee arthroplasty, robotic assistance was the most effective in improving posture and reducing caloric expenditure. In spine surgery, proper use of surgical loupes was the most effective in improving posture. Conclusion Although the reported ranges of our main findings were wide, even on the low end of the reported ranges, work-related musculoskeletal disability among orthopaedic surgeons appears to be a substantial concern. We recommend that orthopaedic residency training programs incorporate surgical ergonomics or work injury lectures, workshops, and film review (alongside existing film review of surgical skills) into their curricula. We suggest hospitals engage in shared decision-making with surgeons through anonymous needs assessment surveys to implement wellness programs specific to surgeons’ musculoskeletal needs. We urge institutions to assess surgeon ergonomics during routine quality assessment of novel surgical instruments and workflows. Level of Evidence Level III, prognostic study.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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High Prevalence of Work-related Musculoskeletal Disorders and Limited Evidence-based Ergonomics in Orthopaedic Surgery: A Systematic Review

Vasireddi,

Shah

et al. 2023

Clin Orthop Relat Res

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Risk Assessment and Prevalence of Work-Related Musculoskeletal Disorders Among Cranial and Spinal Neurosurgeons

2023

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Ergonomics in Spine Surgery

Alostaz,

Bansal,

Gyawali

et al. 2024

Spine

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Study Design. Systematic Review Objective. 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. Summary of Background Data. 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. Methods. 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. Results. Eleven studies met 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 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. Conclusion. This systematic review summarizes the heterogenous 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 period of times in various positions. Studies demonstrate that the 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.

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Prevalence and risk factors of neck pain in spine surgeons - Are we our own patients?

Cited by 7 publications

References 27 publications

High Prevalence of Work-related Musculoskeletal Disorders and Limited Evidence-based Ergonomics in Orthopaedic Surgery: A Systematic Review

High Prevalence of Work-related Musculoskeletal Disorders and Limited Evidence-based Ergonomics in Orthopaedic Surgery: A Systematic Review

Risk Assessment and Prevalence of Work-Related Musculoskeletal Disorders Among Cranial and Spinal Neurosurgeons

Ergonomics in Spine Surgery

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