A systematic review of biomechanical risk factors for the development of work-related musculoskeletal disorders in surgeons of the head and neck

Abstract

BACKGROUND: Previous studies have shown high rates (47–72%) of self-reported work-related musculoskeletal disorders (WRMDs) in surgeons of the head and neck. Physical requirements in the workplace, individual factors (e.g. poor posture, obesity) and psychosocial factors have been identified as risk factors. Establishing biomechanical risk factors may help prevent further development of WRMDs in this population. OBJECTIVE: The purpose of this critical review was to source studies that identified the biomechanical risk factors for WRMDs in this surgical sub-specialty. METHODS: Searches were conducted of Medline, CINAHL, and AMED databases from 1980 until September 2018. RESULTS: A total of 182 article were identified. Exclusion criteria lead to 163 full-text articles being screened, generating a total of 6 articles for review. The aims of the included studies varied significantly. Surgeons spend the majority of operating time in static, asymmetrical positions. Surgical loupes/headlamps significantly increased cervical spine loading. Articulated surgical arm supports provided optimal ergonomic conditions. Performing surgical operations with the surgeon in standing or sitting had no effect on task performance or demand. Physical fatigue was also measured in both positions. CONCLUSIONS: A combination of equipment-based and patient/surgeon position-based factors predispose surgeons to biomechanical risk factors. Studies of greater methodological quality are required.