Reviewed by Lexie CornerApr 22 2024
According to a study published in the Journal of Neurosurgery: Spine, researchers from Baylor College of Medicine collaborated with the University of Arizona to conduct research to assist surgeons in obtaining biofeedback on their posture during lengthy surgical operations. Ultimately, the goal is to lessen the tension caused by maintaining static postures while functioning.
This pilot research assessed the feasibility of utilizing wearable technology to monitor neurosurgeons’ posture during extended spine and cranial surgeries. The findings indicate that wearable technology is a practical and reproducible technique for providing objective feedback required to enhance postural awareness and conduct procedures aimed at modifying posture to prevent musculoskeletal disorders in surgeons.
Wearable technology can identify those periods when neglected postures are more prevalent, enabling prompt correction.
Dr. Alejandro Zulbaran-Roja, Study First Author and Research Associate, Michael E DeBakey Department of Surgery, Baylor College of Medicine
Although neurosurgeons understand that static postures cause considerable harm, the mechanism for measuring their posture is inadequate. The current study employed wearable equipment to measure neurosurgeon upper body spasticity, or muscular stiffness, when bending forwards or backward.
Ten neurosurgeons—five attending physicians and five trainees—were chosen, and each received two wearable sensors fastened to their upper back and the back of their heads. During spinal and cranial operations, the sensors recorded the average time spent in extended, neutral, and flexed static postures.
The researchers successfully collected and analyzed 16 of 20 possible recordings from 11 procedures (eight spine, three cranial).
“We found that surgeons remained in a static posture approximately 52.1 % (38 minutes) and 53.2 % (77.6 minutes) of active surgical time during spine and cranial procedures, respectively. This is a considerable amount of time given that the American College of Surgeons recommends avoiding prolonged static postures by taking mini-breaks at least every 30 minutes to incorporate range-of-motion stretches,” Zulbaran added.
Additionally, the current study demonstrated that during cranial surgery, taller neurosurgeons remained in extended and flexed positions for longer.
Zulbaran stated, “Objective biofeedback can guide surgeons in adjusting their posture in relation to the table height to improve their ergonomics, the interactions with the equipment they use in surgical practice, especially in procedures in which there is constant position switching (standing to sitting and vice versa), as well as tailoring interventions based on specific procedures and level of expertise.”
He continued, “Maintaining an ideal, perfectly straight posture might seem intuitive, but the reality is that surgical procedures often require a range of body positions to access different anatomical structures effectively. Wearable technology can provide self-awareness of static positions that are not always captured or assumed by a simple view. Detecting incorrect motion patterns at early career stages may help emerging surgeons correct their posture and avoid long-term injuries.”
Study corresponding author Dr. Bijan Najafi, professor in the Michael E. DeBakey Department of Surgery, added, “The potential impact and implications of our findings are significant for surgical practice and training. Using wearable technology to monitor and analyze surgeons' posture offers a proactive approach to preventing the onset of musculoskeletal disorders such as back and neck pain. This could lead to improved surgeon health and well-being, enhanced performance, and potentially extended career longevity. Additionally, personalized training programs derived from wearable data could revolutionize surgical education, equipping novice surgeons with the tools to adopt optimal postural habits from the outset of their careers.”
To assess the application of this wearable technology in other specializations, more research is required.
The other study contributors are Mohammad D. Rouzi, Mohsen Zahiri, Abderrahman Ouattas, Christina M. Walter, Hung Nguyen, Sanam Bidadi, and G. Michael Lemole. The authors are affiliated with Baylor College of Medicine or the University of Arizona College of Medicine.
The study was partially funded by Baylor College of Medicine and the Interdisciplinary Consortium on Advanced Motion Performance (iCAMP). The National Institute on Aging awarded additional funds under grant number R44-AG061951-02.
Journal Reference:
Zulbaran-Rojas, A., et. al. (2024) Objective assessment of postural ergonomics in neurosurgery: integrating wearable technology in the operating room. Journal of Neurosurgery: Spine. doi:10.3171/2024.1.SPINE231001