Cervicothoracic Spine Posture Evaluation Among Otolaryngology Head and Neck Surgeons

Abstract

Introduction: Head and neck surgeons at high risk for strain and subsequent complications related to poor posture. We aim to evaluate current ergonomic practices among otolaryngology head and neck surgeons and report cervicothoracic spine posture data from the operating room (OR). Methods: A validated questionnaire evaluating current ergonomic practices was given to participants. A wearable posture device, was calibrated and worn around the neck with the sensor positioned at the mid-scapular region of the upper back. After a full day in the OR, percentage of upright time for the day was recorded. Results: 8 head and neck surgeons, 12 residents, and 4 fellows in training participated in our survey of current ergonomic practices. Over a 2-month period, posture data from the OR was acquired from 5 attendings, 3 fellows and 5 residents on the head and neck service. Changing body position, ignoring discomfort, and specialized footwear were most used to relieve musculoskeletal discomfort while operating. 83.3% of surgeons reported not receiving any formal ergonomics training and were unaware of related guidelines. After morning preparation, posture significantly declined during intraoperative time (p <0.001). There were no significant posture differences by level of training (p= 0.19), or hours spent in the OR (p=0.92). Conclusion: Surgical ergonomics is rarely considered as a point of intervention, but its lack thereof can have serious consequences leading to injury and unresolved day-to-day discomfort. There is a role for ergonomics in case planning, as it has potential to vastly improve surgeon quality of life and career longevity.