title: [Analysis of spinal stress during surgery in otolaryngology].
abstract: BACKGROUND
  Back pain is a common cause of sick leave in industrialized countries. Performing surgery is often associated with considerable cervical spine disorders. However, only a few studies have examined to what extent working posture or individual surgical techniques can be seen as stress indicators.
  
  
  METHODS
  Posture and movement of the spine and trunk were assessed by means of a newly developed analysis system (3-D-SMG). The individual-case study was carried out during six sinus operations using varying techniques (microscope, endoscope or headlamp only).
  
  
  RESULTS
  Spine and trunk deviation from neutral position (upright standing) was strongest in the sagittal plane. Awkward distortions were primarily observed in the cervical and lumbar spine. The analysis of work characteristics revealed static postures in 65-90% of sinus operations. Isometric positions were mainly related to microscopic surgery.
  
  
  CONCLUSIONS
  The data from this explorative individual-case study indicate that prevalence and magnitude of forced isometric and awkward postures are strongly associated with work-related spinal stress in sinus surgery. The new measurement device enables not only the recommendation of individual preventive strategies but also the objective evaluation of ergonomics.
authors.affiliation: Institut für Physiologie und Anatomie, Deutsche Sporthochschule Köln, Am Sportpark Müngersdorf 6, 50933, Köln, Deutschland. m.wunderlich@dshs-koeln.de
authors.forename: M
authors.initials: M
authors.lastname: Wunderlich
authors.forename: R
authors.initials: R
authors.lastname: Jacob
authors.forename: Y
authors.initials: Y
authors.lastname: Stelzig
authors.forename: T
authors.initials: T
authors.lastname: Rüther
authors.forename: D
authors.initials: D
authors.lastname: Leyk
mesh_terms: D001416:Back Pain / Q000503:physiopathology / Q000517:prevention & control; D001696:Biomechanical Phenomena; D002574:Cervical Vertebrae / Q000503:physiopathology; D004724:Endoscopy / Q000009:adverse effects; D006804:Ergonomics; D019416:Head Movements / Q000502:physiology; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation; D021621:Imaging, Three-Dimensional / Q000295:instrumentation; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008866:Microsurgery / Q000009:adverse effects; D009784:Occupational Diseases / Q000503:physiopathology* / Q000517:prevention & control; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects*; D010256:Paranasal Sinuses / Q000601:surgery; D011187:Posture / Q000502:physiology*; D012307:Risk Factors; D012984:Software; D013122:Spinal Diseases / Q000503:physiopathology* / Q000517:prevention & control; D013904:Thoracic Vertebrae / Q000503:physiopathology; D014465:Ultrasonics / Q000295:instrumentation