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Optimizing Minimally Invasive Spine Surgery: A Fully 3D CT O-Arm Navigated Workflow in MIS TLIF
Published on: October 17, 2025
Surgical Spine Techniques for Small-Statured Surgeons and Assistants
Muhammad Talal Ibrahim1, Hannah Harris, A Noelle Larson
1From the Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH (Ibrahim, Harris, and Yu), and the Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN (Larson).
Summary
Operating rooms need improvements for surgeons of all sizes. This review suggests ergonomic tools, microbreaks, and exercises to prevent musculoskeletal injuries for spine surgeons.
Area of Science:
- Orthopedic Surgery
- Ergonomics
- Occupational Health
Background:
- Current operating room (OR) designs may not accommodate all surgeons, potentially impacting their well-being and performance.
- Spine surgeons, in particular, may face ergonomic challenges due to non-stereotypical body sizes.
Purpose of the Study:
- To review and suggest improvements for OR environments to ensure an equitable workspace for all surgeons.
- To provide practical strategies for spine surgeons to mitigate musculoskeletal injury risks.
Main Methods:
- Literature review of ergonomic principles and OR design.
- Analysis of surgical tools, equipment, and workplace modifications.
- Discussion of physical conditioning and break strategies for surgeons.
Main Results:
- Recommendations include adopting good posture, utilizing powered and ergonomically designed tools, and employing body support devices.
- Emphasis on selecting tools with greater leverage (e.g., T-handles) when specialized equipment is unavailable.
- Integration of microbreaks (under 1 minute every 30 minutes) for stretching and strain reduction is advised.
Conclusions:
- Implementing ergonomic best practices within the OR is essential for surgeon well-being.
- A combination of in-OR modifications and out-of-OR physical conditioning (strength training, stretching, aerobic exercise) can minimize musculoskeletal injury risk.

