1086 Surgical Posture With Microscopic Versus Exoscopic Visualization in Anterior Cervical Procedures

INTRODUCTION: Workplace posture has long been associated with back and neck pain, and surgeons are not exempt. Though intraoperative surgeon posture has progressively improved with the visualization of the operative microscope, surgeons nonetheless continue to sustain deviated postures during operations which may result in increased rates of neck and back pain. The surgical exoscope is designed to improve surgical ergonomics. This study aims to quantify the difference in posture during standard anterior cervical spine procedures when performed with the aid of an operative microscope versus an exoscope. METHODS: This is a prospective cohort study utilizing the MetaWare MetaMotion S device placed at the surgeon’s cervicothoracic junction to measure Euler angles of upper thoracic spine during each case. Primary outcome was the percentage of time spent with greater than 10deg deviation from a surgeon’s baseline posture while using either the microscope or the exoscope. Additional metrics were analyzed for average deviation from baseline for each axis, as well was percentage of operative time spent with the microscope or the exoscope. RESULTS: Overall, 37 anterior cervical procedures were recorded, 18 performed with an exoscope and 19 with a microscope. Surgeons spent significantly more time in a deviated posture with the operative microscope than with the exoscope (32% vs 8% with x-axis >10 deg, p < 0.005; 20% vs 6% with y-axis >10 deg, p < 0.05). This is also reflected with significant differences in the average deviation in the x- and y- axis while under scope. CONCLUSIONS: Utilizing the exoscope for anterior cervical spine procedures allowed for less time spent in deviated posture.