Surgical Posture with Microscopic Versus Exoscopic Visualization in Anterior Cervical Procedures

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Surgical Technology

Background:

• Surgeons often adopt deviated postures during procedures, even with loupes or microscopes.
• The surgical exoscope offers potential ergonomic benefits, but objective data are lacking.
• Previous studies highlight the prevalence of poor surgical ergonomics.

Purpose of the Study:

• To quantify the difference in surgeon posture during anterior cervical spine surgery using an operative microscope versus a surgical exoscope.
• To evaluate the impact of visualization technology on surgical ergonomics.
• To provide objective data on surgeon posture during cervical spine procedures.

Main Methods:

• Prospective cohort study involving 37 anterior cervical spine procedures.
• Utilized a posture-sensing device to measure cervicothoracic junction angles.
• Defined deviated posture as >10 degrees of flexion/extension or lateral bending.

Main Results:

• Surgeons spent significantly less time in deviated postures with the exoscope (8% vs. 32% for x-axis, 6% vs. 20% for y-axis).
• Exoscope use resulted in significantly less average deviation in the x- and y-axes.
• P-values <0.005 for x-axis and <0.05 for y-axis deviations.

Conclusions:

• The surgical exoscope improves surgeon ergonomics during anterior cervical spine procedures.
• Surgeons utilizing the exoscope spend significantly less time in deviated postures.
• This technology represents a significant advancement in reducing physical strain for spine surgeons.