O218: Biomechanical and Ergonomic Risks Associated with Cervical Musculoskeletal Dysfunction amongst Surgeons: A Systematic Review

Abstract

Abstract Introduction Surgeons are at high risk of developing musculoskeletal symptoms due to a range of factors including, maladaptive positioning, surgical ergonomics, and surgeon characteristics. Cervical muscle strain and biomechanical load is most prevalent due to repetitive motions and prolonged static neck positioning1. However, recommendations to improve cervical health of surgeons are limited. This issue is apparent through reports of prevalence between 10 – 74.4% among surgeons2,3. The aim of this systematic review is to provide an objective assessment of the clinical evidence available and a descriptive analysis of the effects of kinematics and surgical ergonomics on the prevalence of surgeons’ cervical musculoskeletal pain. Results A total of 2474 articles were identified on initial search, of which 1046 were duplicates and were removed from review. Abstracts and full texts remaining were then screened, with 9 studies included in the final qualitative analysis. The use of loupes, open surgery and excessive neck flexion (> 30 degrees) were associated with cervical dysfunction. Comparison of study outcomes was challenging due to heterogeneity within study methods and the paucity of methodological quality. This precluded formal meta-analysis. Conclusion The current literature assessing ergonomic and biomechanical factors predisposing surgeons to cervical musculoskeletal dysfunction is insufficient to provide reliable guidance for clinicians. Although the literature has identified factors that contribute to work-related cervical dysfunction, few have attempted to evaluate interventions for improved surgical ergonomics. An objective assessment of interventions that promote postural correction with the aim to improve neck pain scores in surgeon cohorts is warranted.