Intraoperative Electromyogram Analysis of Postural Musculature With Three-dimensional Screen Display Versus Operating Microscope in Ophthalmic Surgery: A Clinical Methods Study.
Arjan S Hura, Moshe A Mizrahi, Charu D Eluvathingal, John G Quinlan, Robert W Neel, Christopher D Riemann
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Abstract
Background and objective: To objectively analyze the effect of three-dimensional screen-based surgery (3D SBS) versus traditional operating microscope (TOM) on operating surgeon posterior chain postural musculature during ophthalmic surgery. We hypothesized an increase in median amplitude of electromyography (EMG) signals when using a TOM compared to 3D SBS. The goal was to assess surgical ergonomics that may contribute to cervical and lumbar spine pathology. EMG analysis was conducted at the University of Cincinnati Medical Center Epilepsy Monitoring Unit. Data were collected in the private practice setting at Cincinnati Eye Institute.
Materials and methods: This was an institutional review board exempt, nonrandomized, prospective, single center, n = 1 clinical methods study. EMG surface electrodes were affixed to the bilateral splenius capitis, sternocleidomastoid, upper trapezius, anterior deltoid, and quadratus lumborum musculature. EMG data were collected across four sessions consisting of one day each using 3D SBS or a TOM, and two cross-over days. A survey regarding surgeon comfort was administered before, during, and after each surgery, and at the end of each day.
Results: EMG cross-over data demonstrated an increase in muscle activation in all measured muscles except the anterior deltoids and right quadratus lumborum with use of a TOM. Survey data showed increased fatigue when using a TOM relative to 3D SBS.
Conclusion: EMG demonstrated increased postural muscle activation when utilizing TOM relative to 3D SBS. Similar to previous studies, our survey data suggest inferior ergonomics of TOM relative to 3D SBS. [Ophthalmic Surg Lasers Imaging Retina 2024;55:XX-XX.].
背景和目的：客观分析三维屏幕手术（3D SBS）与传统手术显微镜（TOM）对眼科手术中外科医生后链姿势肌肉的影响。我们假设，与三维 SBS 相比，使用 TOM 时肌电图 (EMG) 信号的中值振幅会增加。我们的目标是评估可能导致颈椎和腰椎病变的手术工效学。EMG 分析在辛辛那提大学医学中心癫痫监测室进行。数据是在辛辛那提眼科研究所的私人诊所收集的：这是一项获得机构审查委员会豁免的非随机、前瞻性、单中心、n = 1 临床方法研究。EMG表面电极贴在双侧脾帽肌、胸锁乳突肌、斜方肌上部、三角肌前部和腰方肌上。在四个疗程中收集 EMG 数据，每个疗程包括一天使用 3D SBS 或 TOM，以及两天交叉使用。在每次手术前、手术中、手术后以及每天手术结束时，都对外科医生的舒适度进行了调查：结果：EMG 交叉数据显示，使用 TOM 时，除三角肌前部和右腰四头肌外，所有测量肌肉的活化程度都有所提高。调查数据显示，相对于 3D SBS，使用 TOM 会增加疲劳感：EMG显示，与三维SBS相比，使用TOM时姿势肌肉激活增加。与之前的研究类似，我们的调查数据表明，TOM 的人体工学效果不如 3D SBS。[眼科手术激光成像视网膜2024;55:XX-XX]。
期刊介绍：
OSLI Retina focuses exclusively on retinal diseases, surgery and pharmacotherapy. OSLI Retina will offer an expedited submission to publication effort of peer-reviewed clinical science and case report articles. The front of the journal offers practical clinical and practice management features and columns specific to retina specialists. In sum, readers will find important peer-reviewed retina articles and the latest findings in techniques and science, as well as informative business and practice management features in one journal.
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