Published in the Journal of Neurosurgery: Spine, a pilot study was carried out by researchers at Baylor College of Medicine in collaboration with the University of Arizona to evaluate the feasibility of using wearable technology to assess the posture of neurosurgeons during long spine and cranial procedures.

The findings validate the theory that wearable technology can be applied effectively to provide objective feedback to raise postural awareness and implement protocols focused on correcting posture to prevent musculoskeletal issues in surgeons.

“Wearable technology can identify those periods when neglected postures are more prevalent, enabling prompt correction,” said first author of the work Dr Alejandro Zulbaran-Rojas, research associate in the Michael E DeBakey Department of Surgery at Baylor College of Medicine.

Although neurosurgeons are aware that static postures cause significant harm, the methodology for assessing their posture is considered suboptimal. The present study used wearable technology to quantify neurosurgeon upper-body spasticity, or muscle stiffness, either when leaning forwards or backwards.

Ten neurosurgeons, including five attendings and five trainees, were recruited and equipped with two wearable sensors attached to the back of their head and their upper back. The sensors collected the average time spent in extended, neutral, and flexed static postures during spine and cranial procedures.

The researchers successfully collected and analysed 16 of 20 possible recordings from 11 procedures (eight spine, three cranial).

“We found that surgeons remained in a static posture approximately 52.1 per cent (38 minutes) and 53.2 per cent (77.6 minutes) of active surgical time during spine and cranial procedures, respectively,” Zulbaran said. “This is a considerable amount of time, given that the American College of Surgeons recommends avoiding prolonged static postures by taking mini-breaks at least every 30 minutes to incorporate range-of-motion stretches.”

The present study also showed that taller neurosurgeons spent longer time in flexed and extended positions during cranial surgery.

Said Zulbaran: “Objective biofeedback can guide surgeons in adjusting their posture in relation to the table height to improve their ergonomics, the interactions with the equipment they use in surgical practice, especially in procedures in which there is constant position switching (standing to sitting and vice versa), as well as tailoring interventions based on specific procedures and level of expertise.”

Maintaining a perfectly straight posture might seem intuitive, Zulbaran explained, but surgical procedures often demand the surgeon adopts a range of body positions to access different anatomical structures.

“Wearable technology can provide self-awareness of static positions that are not always captured or assumed by a simple view,” he added. “Detecting incorrect motion patterns at early career stages may help emerging surgeons correct their posture and avoid long-term injuries.”

Corresponding author Dr Bijan Najafi, a professor in the Michael E. DeBakey Department of Surgery, observed: “The potential impact and implications of our findings are significant for surgical practice and training. Using wearable technology to monitor and analyse surgeons’ posture offers a proactive approach to preventing the onset of musculoskeletal disorders, such as back and neck pain. This could lead to improved surgeon health and wellbeing, enhanced performance, and potentially extended career longevity.

“Additionally, personalised training programmes derived from wearable data could revolutionise surgical education, equipping novice surgeons with the tools to adopt optimal postural habits from the outset of their careers.”

Future studies are needed to evaluate the use of this wearable technology in other specialties.