How Loud is Minimally Invasive Spine Surgery? Identifying Intraoperative Risk of Hearing Loss.

Area of Science:

• Neurosurgery
• Audiology
• Occupational Health

Background:

• Surgical environments can expose personnel to high noise levels.
• Noise-induced hearing loss (NIHL) is a concern for healthcare professionals.
• Understanding sound pressure levels (SPL) during spine procedures is crucial for risk assessment.

Purpose of the Study:

• To quantify SPL variations during common spine surgeries.
• To identify surgical phases with elevated noise levels.
• To assess the risk of NIHL for surgeons based on SPL data.

Main Methods:

• Prospective cohort study design.
• Sound pressure levels (SPL) measured using a microphone on the surgeon's collar.
• Data collected during Minimally Invasive Transforaminal Lumbar Interbody Fusion (MI-TLIF), microdiscectomy, and decompression procedures.
• Average (ADL) and maximum (MDL) SPLs calculated for each phase and compared across procedure types and instruments.

Main Results:

• Significant differences in ADL observed across all three procedure types.
• The irrigation/closure phase consistently showed the lowest ADL and mMDL.
• Facetectomy (MI-TLIF), laminotomy (microdiscectomy), and laminectomy (decompression) phases exhibited the highest noise levels.
• One electric burr (Brand A-e) demonstrated significantly lower ADL and MDL compared to others.

Conclusions:

• Phases utilizing powered instruments (burrs, electrocautery, suction) in spine surgery are associated with higher SPLs.
• Although average SPLs may remain below dangerous thresholds, short-term peaks above 85 dBA can occur.
• While overall NIHL risk may be low, specific high-noise phases necessitate attention for hearing protection strategies.