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Spine surgeon's kinematics during discectomy, part II: operating table height and visualization methods, including microscope.

Authors
 Jeong Yoon Park  ;  Kyung Hyun Kim  ;  Sung Uk Kuh  ;  Dong Kyu Chin  ;  Keun Su Kim  ;  Yong Eun Cho 
Citation
 EUROPEAN SPINE JOURNAL, Vol.23(5) : 1067-1076, 2014 
Journal Title
 EUROPEAN SPINE JOURNAL 
ISSN
 0940-6719 
Issue Date
2014
MeSH
Biomechanical Phenomena ; Diskectomy/methods* ; Humans ; Lordosis/surgery ; Models, Biological ; Operating Tables/standards* ; Surgeons/statistics & numerical data*
Abstract
PURPOSE: Surgeon spine angle during surgery was studied ergonomically and the kinematics of the surgeon's spine was related with musculoskeletal fatigue and pain. Spine angles varied depending on operation table height and visualization method, and in a previous paper we showed that the use of a loupe and a table height at the midpoint between the umbilicus and the sternum are optimal for reducing musculoskeletal loading. However, no studies have previously included a microscope as a possible visualization method. The objective of this study is to assess differences in surgeon spine angles depending on operating table height and visualization method, including microscope. MATERIALS AND METHODS: We enrolled 18 experienced spine surgeons for this study, who each performed a discectomy using a spine surgery simulator. Three different methods were used to visualize the surgical field (naked eye, loupe, microscope) and three different operating table heights (anterior superior iliac spine, umbilicus, the midpoint between the umbilicus and the sternum) were studied. Whole spine angles were compared for three different views during the discectomy simulation: midline, ipsilateral, and contralateral. A 16-camera optoelectronic motion analysis system was used, and 16 markers were placed from the head to the pelvis. Lumbar lordosis, thoracic kyphosis, cervical lordosis, and occipital angle were compared between the different operating table heights and visualization methods as well as a natural standing position. RESULTS: Whole spine angles differed significantly depending on visualization method. All parameters were closer to natural standing values when discectomy was performed with a microscope, and there were no differences between the naked eye and the loupe. Whole spine angles were also found to differ from the natural standing position depending on operating table height, and became closer to natural standing position values as the operating table height increased, independent of the visualization method. When using a microscope, lumbar lordosis, thoracic kyphosis, and cervical lordosis showed no differences according to table heights above the umbilicus. CONCLUSION: This study suggests that the use of a microscope and a table height above the umbilicus are optimal for reducing surgeon musculoskeletal fatigue.
Full Text
http://link.springer.com/article/10.1007/s00586-013-3125-6
DOI
10.1007/s00586-013-3125-6
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kuh, Sung Uk(구성욱) ORCID logo https://orcid.org/0000-0003-2566-3209
Kim, Kyung Hyun(김경현)
Kim, Keun Su(김근수) ORCID logo https://orcid.org/0000-0002-3384-5638
Park, Jeong Yoon(박정윤) ORCID logo https://orcid.org/0000-0002-3728-7784
Cho, Yong Eun(조용은) ORCID logo https://orcid.org/0000-0001-9815-2720
Chin, Dong Kyu(진동규) ORCID logo https://orcid.org/0000-0002-9835-9294
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138304
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