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Related Concept Videos

Anatomical Positions01:11

Anatomical Positions

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In anatomy, several standard anatomical positions are used as references for describing the position and orientation of different body parts. These positions help provide a common frame of reference when discussing anatomical structures. The anatomical position is the standard reference point for describing the body's position and orientation. In this position:
The body is upright, facing forward, and standing erect.
The feet are parallel and flat on the floor.
The arms are hanging by the...
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Using the Craniovertebral Angle to Quantify Intraoperative Ergonomic Risk.

Natalie Kelly1, Marike Mousset1, Abdulrahman Althubaiti1

  • 1Department of Pediatric Otolaryngology-Head & Neck Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|January 18, 2022
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Summary
This summary is machine-generated.

Surgeons often adopt poor neck posture during tonsillectomy, increasing ergonomic risk. The craniovertebral angle (CVA) measurement is reliable for assessing this risk and identifying abnormal postures during surgery.

Keywords:
Rapid Upper Limb Assessmentcraniovertebral angleergonomicsoccupational hazardotolaryngology

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Area of Science:

  • Surgical ergonomics
  • Occupational health
  • Anatomy

Background:

  • Tonsillectomy procedures require surgeons to maintain specific neck postures.
  • Poor surgical ergonomics can lead to intraoperative risks and long-term health issues for surgeons.
  • The craniovertebral angle (CVA) is a potential metric for assessing neck posture during surgery.

Purpose of the Study:

  • To measure the craniovertebral angle (CVA) during tonsillectomy.
  • To evaluate the interrater reliability of CVA measurement methodology.
  • To explore correlations between the Rapid Upper Limb Assessment (RULA) and CVA for quantifying ergonomic risk.

Main Methods:

  • A prospective, observational study was conducted at a tertiary care pediatric institution.
  • Lateral images of surgeons were captured every minute during tonsillectomy procedures (n=92 images from 7 surgeons).
  • Three raters measured the CVA, defined as the angle between a horizontal line through C7 and a line from C7 to the tragus, with abnormal posture defined as CVA < 50°.

Main Results:

  • The mean CVA during tonsillectomy was 26.0° (SD 11.3°).
  • 100% of procedures showed at least one assessment of abnormal neck posture (CVA < 50°).
  • The lowest interrater reliability for CVA measurement was 0.77; RULA and CVA showed a null correlation (r = -0.12, P = .27).

Conclusions:

  • Poor neck posture is prevalent during tonsillectomy, posing significant intraoperative ergonomic risks to otolaryngologists.
  • The CVA is a reliable and validated tool for assessing surgical ergonomics and identifying pathologic neck positions.
  • While RULA and CVA are complementary, CVA serves as a predictor of future neck pain.