Here’s How Spine Surgeons Train to Keep Back Pain at Bay
It’s ironic that spine surgeons suffer from bad backs. The doctors are not immune to the physical demands of their profession and research suggests that neck and back pain as well as other work-related musculoskeletal problems are common among surgeons who spend hours performing complex procedures in demanding positions.
In a survey of 180 practicing spine surgeons, nearly 75% reported experiencing neck pain within the previous 30 days. Another longitudinal study found that 88% of spine surgeons experienced work-related musculoskeletal disorders during their careers.
It’s understandable. Spine surgery can require surgeons to remain in the same position for hours, often leaning, twisting or looking down toward the surgical field. Specialized surgical equipment used in minimally invasive procedures requires surgeons to work at extreme angles and create additional ergonomic challenges leading to discomfort.
The repetitive, highly precise movements required during surgery can also put stress on the shoulders, wrists and hands. And when procedures involve X-ray guidance, surgeons may wear lead protective aprons that can weigh as much as 20 pounds, adding to the physical demands on the back. After decades in the OR, these stresses can add up.
Robotic-assisted and computer-navigated surgery are increasingly being used in spine procedures, primarily because they can help surgeons plan and execute procedures with greater precision and consistency. Increasingly they’re found to be a major contributor to a surgeon’s working environment.
Robotic systems can help surgeons guide surgical instruments along a preplanned trajectory and this technology also can help surgeons maintain a more neutral working position rather than constantly leaning or bending toward the surgical site.
Navigation technology may also reduce the need for repeated intraoperative fluoroscopy in some procedures. Less reliance on fluoroscopy can mean less time wearing heavy lead protective aprons.
The new technology helps but is only part of the equation. For spine surgeons, taking care of their own backs may also require something much simpler: staying strong and flexible.
Dr. Jeremy Smith, Division Chief of Spine Surgery at Hoag Orthopedic Institute, says maintaining his own physical health is an important part of staying healthy throughout his career.
“I learned early on that a critical component of my own professional success is prioritizing my own spine health,” Smith said. “I am up at 4:30 a.m. every day, incorporating both strength and flexibility training to keep in shape both in and out of the operating room.”
To keep your back in shape, here’s what Dr. Smith recommends:
Building a stronger core: Exercises such as bird dogs, dead bugs and planks can strengthen the abdominal and core muscles that help support the lower back.
Strengthening the hips and glutes: Glute bridges and resistance-band exercises can help strengthen the muscles around the hips and support the lower back.
Strength training: Exercises such as rows and lat pulldowns can strengthen the back and shoulders. Deadlifts can also be part of a strength-training program, but proper technique is important, particularly for people who are new to lifting weights.
Keep moving and stay flexible: Gentle stretching and activities such as yoga can improve flexibility and range of motion. Simple movements such as cat-cow, cobra and child's pose may help relieve muscle tension and stiffness.
For patients, as well as surgeons, Smith says, “Focus on exercises that strengthen the muscles supporting the spine while maintaining flexibility.”
About the Author:
Jeremy Smith, MD, is a fellowship trained orthopedic spine surgeon and the Division Chief of Spine Surgery at Hoag Orthopedic Institute.