A RELEVANT SOLUTION TO SURGICAL ERGONOMIC DISTRESS

A RELEVANT SOLUTION TO SURGICAL ERGONOMIC DISTRESS NekSpineTM

Introducing a spinal support exoskeleton designed to reduce the stress on the cervical, thoracic, and lumbar spine regions experienced during surgical and dental procedures.

Written by Alvin C. Mayshack, MSME
Director of Marketing, Composite Manufacturing Incorporated

Introduction

The physicality required to perform surgery necessitates awareness of the stress and strain placed on the body and requires action from the clinician to protect themselves. At risk is the short term and future quality of life and potentially, longevity of their careers. Effort has gone forth in industry to develop mitigations. Proper positioning of monitors, ergonomic focused instrumentation, awareness training on forward head positions, improper shoulder elevation, postural reset and motion strategies are all mitigations that have been introduced in the past to attempt to help the surgeon counterbalance the prolonged and awkward positions that can lead to pain, fatigue and degenerative changes.1

The OR is a stressful environment which can be further magnified by the physical requirements of attaining surgical access and visibility for long periods of time. Pain impacts work in many ways beginning with the physical challenges but it also can affect communication and collaboration especially in a dynamic surgical environment. Negative emotions are contagious especially when they emanate from leadership in the room. Ultimately, in the OR and in the dental operatory the patient comes first. Clinicians commonly accept the fact that pain and discomfort is part of the job. It is almost a badge of honor to be able to push through and sacrifice for the patient.

The white paper authored by Heather Kookier 2022
titled, “Do No Let Poor Ergonomics Cut your Career
Short: Heavy is the Head”2, tackles the awareness of
the growing trend of Musculoskeletal disorders in the
surgical and dental community. Kookier sites one of the more popular mitigations that is growing in practice is Targeted Stretching Micro Breaks (TSMBS) which has proven to provide some level of relief and aid in mental focus but does come with the tradeoff of increased time to the procedure.3 Other solutions such as haptic feedback remind the user of their position and depend on the user to act which may or may not be possible based on the situation and requirements for surgical access.

A solution that lends itself more appropriately to the environment is one that is more passive in nature and would not require a response and action from the user. That solution would allow the user unrestricted movement, create postural awareness, and still accomplish its purpose of reducing the wear and tear that occurs over time due to repetitive stress. That solution is the NekSpine Exoskeleton.

NekSpineTM by CMI (Composite

Manufacturing Inc.)

NekSpineTM is a biomedically engineered spinal support system designed to reduce the stress on the cervical, thoracic and lumbar spine regions experienced during routine repetitive and awkward positions necessary for access during surgical and dental procedures. The product allows free range of motion while providing prophylactic care for the user. The user invests a small amount of time up front in determining their comfort settings and becoming familiar with the feel of the device. From there, the product can be used daily as a normal part of the PPE or on a case-by-case basis as determined by the length and expected stress during cases.

NeKSpine utilizes a lightweight vest with an integrated carbon fiber spine member used in conjunction with a lightweight carbon fiber head frame to provide support specifically targeted at the cervical region but also along the entire spine.

THE BODY VEST

Manufactured from a lightweight, strong material commonly used in military applications where weight, breathability and durability are key performance characteristics. Laser cut and optimized for weight, support, padding and fit, the vest comes in multiple sizes designed to cover the population of body sizes and shapes.

The posture supporting/correcting lumbar support system of the vest provides trunk compression and stability and is ideal for active positions required by surgical and dental procedures.

Cinching the shoulder straps and chest strap helps to maintain good shoulder posture. The padded shoulders and waist allow the vest to do its job of facilitating the transfer of load from the cervical spine with comfort.

THE SUPPORT BEAM

The support beam is a carbon fiber I-beam structure tuned to provide the proportional counterbalance to offset the load of the head. The support beam is integrated into the vest and provides structure along

the cervical, thoracic and lumber regions along the entire spine. The tie-in of the beam to the vest and the head frame facilitates the load transfer of the head to the hips. The I-beam composite structure provides a critical performance characteristic of having high stiffness to weight ratio. 20% of the weight of steel but with a 3X strength factor, the combination of the beam and ergonomic vest design provides the user with a comfortable but highly effective biologically engineered device.

HEAD FRAME

The head frame provides the means to connect the user’s head to the spine beam via a titanium Teflon coated wire. It is termed a frame verses a head band because its function is different than that of a surgical headlight band. The NekSpine Head Frame is fabricated from lightweight and extremely strong carbon fiber. Rigidity is a key component to facilitating the load transfer while ergonomically interfacing with the bony structures of the user’s head.

The head frame can be adjusted to fit the user’s head structure in the same manner as a traditional head light band. The top knob adjusts the cap depth and the rear knob is used to adapt to the head circumference. The critical function of the head frame is facilitated by the connection of the slider block to the carbon spine via a rolling titanium wire. The wire moves smoothly through the slider block allowing for unrestricted head turn motion.

The color-coded tension adjustment knobs on each side of the frame allow the user to counterbalance the head forward load to the desired level. That level can be light or heavy based on the application. A heavier application of tension may be desired for those cases longer in duration that require extensive head forward positioning.

For those surgeons that utilize headlamps for additional illumination, NekSpine offers the Quasar Premium Headlight System which is integrated directly into the head frame. For surgeons or dentists with other headlamp preferences, CMI can mount your brand directly to the NekSpine.

Conclusion

NekSpine is the first and only true solution to address the issue of cervical stress experienced during procedures. This wearable system integrates seamlessly into the surgeon or dentist workflow to provide prophylactic care of the entire spine. The integration of this solution into the surgeon or dentist’s daily routine can improve the quality of life today and potentially extend the viability of your career for tomorrow.

References

1. Andrew T. Schlussel, Justin A. Maykel, “Ergonomics and Musculoskeletal Health of the Surgeon”, Clinics in Colon and Rectal Surgery, 2019: 32(06): 424 – 434

2. Heather Kookier, MSN, RN, CML, CNOR, DRNFA; “Do Not Let Poor Ergonomics End Your Caregiving Career: Heavy is the Head”, 2022.

3. Adrian E Park, “Intraoperative “Micro Breaks” With Targeted Stretching Enhance Surgeon Physical Function and Mental Focus: A Multicenter Cohort Study”, Annals of Surgery, 2017 Feb; 265(2): 340- 346

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