Quantifying the lumbar spine movements of surgeons during surgical lists in a teaching hospital

Abstract

Background: Low back pain (LBP) is a common occupational musculoskeletal complaint among health professionals. No research has quantified lumbar movement patterns in the surgical workplace, identifying ‘at risk’ behaviours with objective measures. This project aimed to identify lumbar movement patterns and change in LBP of surgeons and surgical trainees during a surgical list. Methods: Surgeons or surgical trainees were recruited in a tertiary metropolitan hospital. Low back movements were quantified in real time via a monitoring system. This measured three-dimensional movement, velocity, acceleration and orientation to gravity during a typical theatre session. Pre- and post-surgery LBP, or low back injury measures of functional disability were quantified using the Oswestry disability index. Mean (standard deviation) and median (interquartile range) low back movement patterns were described. A Wilcoxon signed-rank test determined differences in LBP recorded from beginning to end of recording periods. Results: Participants (n = 28) recorded data for a mean (standard deviation) of 6.1 (2.2) h. On average, 27.7 lumbar flexion events were recorded per monitoring session, with flexion movements held for >30 s an average of 5.6 times. Many of the flexion events were considered low range (between 20° and 40°) with an average of 19.1 events per session. Orthopaedic trainees recorded the highest average of lumbar and sustained lumbar flexions per hour (4.13 times). LBP significantly increased over the work day (z = −2.53, P = 0.012). Conclusion: This study provides a base for the understanding of low back movement patterns during surgery. This data may be useful in helping surgeons to identify their ‘high risk’ movements and prevent low back symptoms.