Conrad Shaw1, Rabia Bourkiza2, Louisa Wickham2, Ian Mccarthy3, Cordelia Mckechnie4. 1. University College London, London, England. Electronic address: conrad.shaw.10@ucl.ac.uk. 2. Moorfields Eye Hospital, London, England. 3. Moorfields Eye Hospital, London, England; Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, Brockley Hill, England. 4. Department of Ophthalmology, Barts Health NHS Trust, London, England.
Abstract
OBJECTIVE: Vitreoretinal (VR) surgeons have high rates of spinal pain. The aim of this study was to investigate if VR surgeons adopt more complex postures in indirect ophthalmoscopy procedures compared with procedures involving the slit-lamp or operating microscope. METHODS: Postures of the neck, back, and overall spine were measured by inclinometers on 13 VR surgeons. Each doctor was measured during 3 indirect examinations and 3 slit-lamp examinations (SLE), and then during 1 operating microscope procedure (phacoemulsification/vitrectomy) and 1 indirect procedure (indirect laser or cryotherapy/buckle). RESULTS: The average degree of flexion of neck/back/overall spine was significantly higher in indirect examinations compared with SLE (p < 0.01). SLE involved mainly neutral flexion, whereas indirect examinations involved significant time in moderate flexion of the neck and overall spine (42.2% and 76.2%, respectively), lateral bending of the back and overall spine (62.5% and 38%), and rotation of the neck and overall spine (76.6% and 32.1%). For indirect procedures, the neck was in moderate flexion and rotation approximately half of the time, and the overall spine was moderately flexed in >75% of the time. CONCLUSION: Based on biomechanical concepts, VR surgeons are at risk of developing spinal pain because they adopt postures that are described as ergonomically unacceptable.
OBJECTIVE:Vitreoretinal (VR) surgeons have high rates of spinal pain. The aim of this study was to investigate if VR surgeons adopt more complex postures in indirect ophthalmoscopy procedures compared with procedures involving the slit-lamp or operating microscope. METHODS: Postures of the neck, back, and overall spine were measured by inclinometers on 13 VR surgeons. Each doctor was measured during 3 indirect examinations and 3 slit-lamp examinations (SLE), and then during 1 operating microscope procedure (phacoemulsification/vitrectomy) and 1 indirect procedure (indirect laser or cryotherapy/buckle). RESULTS: The average degree of flexion of neck/back/overall spine was significantly higher in indirect examinations compared with SLE (p < 0.01). SLE involved mainly neutral flexion, whereas indirect examinations involved significant time in moderate flexion of the neck and overall spine (42.2% and 76.2%, respectively), lateral bending of the back and overall spine (62.5% and 38%), and rotation of the neck and overall spine (76.6% and 32.1%). For indirect procedures, the neck was in moderate flexion and rotation approximately half of the time, and the overall spine was moderately flexed in >75% of the time. CONCLUSION: Based on biomechanical concepts, VR surgeons are at risk of developing spinal pain because they adopt postures that are described as ergonomically unacceptable.