与外科医生颈椎肌肉骨骼功能障碍相关的生物力学和人体工程学风险:系统综述。

K. O'Reilly , J.M. McDonnell , S. Ibrahim , J.S. Butler , J.D. Martin-Smith , J.B. O'Sullivan , R.T. Dolan
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引用次数: 0

摘要

简介:由于不适应的体位和手术工效学等一系列因素,外科医生很容易出现肌肉骨骼症状。颈部肌肉劳损和生物力学负荷最常见的原因是重复性动作和颈部长时间静态定位。有报告称,外科医生的发病率在 10% 到 74.4% 之间,由此可见这一问题的严重性。本系统性综述旨在对现有的临床证据进行客观评估,并对运动学和手术人体工程学对外科医生颈部肌肉骨骼疼痛发生率的影响进行描述性分析:本研究通过检索 PUBMED 和 Ovid EMBASE 数据库,对评估外科医生颈椎肌肉骨骼功能障碍患病率的临床研究进行了系统性综述,研究时间从开始至 2023 年 10 月 19 日,符合 PRISMA 标准。研究质量根据美国国立卫生研究院研究质量评估工具进行分级:最终定性分析共纳入了 9 项研究。使用放大镜、开放手术和颈部过度屈曲(>30°)与颈椎功能障碍有关。由于研究方法的异质性和方法学质量的欠缺,比较研究结果具有挑战性:目前评估导致外科医生颈椎肌肉骨骼功能障碍的人体工程学和生物力学因素的文献还不足以为临床医生提供可靠的指导。虽然文献指出了导致工作相关颈椎功能障碍的因素,但很少有文献试图评估改善手术人体工程学的干预措施。有必要对旨在改善外科医生群体颈部疼痛的姿势矫正干预措施进行客观评估。
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Biomechanical and ergonomic risks associated with cervical musculoskeletal dysfunction amongst surgeons: A systematic review

Introduction

Surgeons are at high risk of developing musculoskeletal symptoms due to a range of factors including, maladaptive positioning and surgical ergonomics. Cervical muscle strain and biomechanical load is most prevalent due to repetitive motions and prolonged static neck positioning. This issue is apparent through reports of prevalence between 10 and 74.4% among surgeons. The aim of this systematic review is to provide an objective assessment of the clinical evidence available and a descriptive analysis of the effects of kinematics and surgical ergonomics on the prevalence of surgeons' cervical musculoskeletal pain.

Methods

This is PRISMA-compliant systematic review of clinical studies assessing the prevalence of cervical musculoskeletal dysfunction in surgeons by searching PUBMED and Ovid EMBASE databases from inception to 19th October 2023. Study quality was graded according to the National Institutes of Health study quality assessment tools.

Results

A total of 9 studies were included in the final qualitative analysis. The use of loupes, open surgery and excessive neck flexion (>30°) were associated with cervical dysfunction. Comparison of study outcomes was challenging due to heterogeneity within study methods and the paucity of methodological quality.

Conclusion

The current literature assessing ergonomic and biomechanical factors predisposing surgeons to cervical musculoskeletal dysfunction is insufficient to provide reliable guidance for clinicians. Although the literature identifies factors contributing to work-related cervical dysfunction, few attempt to evaluate interventions for improved surgical ergonomics. An objective assessment of interventions that prompt postural correction with the aim to improve neck pain in surgeon cohorts is warranted.

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来源期刊
CiteScore
4.40
自引率
0.00%
发文量
158
审稿时长
6-12 weeks
期刊介绍: Since its establishment in 2003, The Surgeon has established itself as one of the leading multidisciplinary surgical titles, both in print and online. The Surgeon is published for the worldwide surgical and dental communities. The goal of the Journal is to achieve wider national and international recognition, through a commitment to excellence in original research. In addition, both Colleges see the Journal as an important educational service, and consequently there is a particular focus on post-graduate development. Much of our educational role will continue to be achieved through publishing expanded review articles by leaders in their field. Articles in related areas to surgery and dentistry, such as healthcare management and education, are also welcomed. We aim to educate, entertain, give insight into new surgical techniques and technology, and provide a forum for debate and discussion.
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