ArticleOrthopaedic surgery2023
Beyond Magnification and Illumination: Ergonomics with a 3D Exoscope in Lumbar Spine Microsurgery to Reduce Musculoskeletal Injuries.
Article in Orthopaedic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Exoscope versus microscope in spine surgery: A meta-analysis based on procedure-specific subgroup analysis.Neurosurgical review · 2026Pooled it
- Gender-Specific Occupational Hazards in Orthopedic Surgery: Survey of Women Surgeons in South Asia.Indian journal of orthopaedics · 2025Article
- Craniotomy Complexity and Outcomes in Exoscope-Assisted Cranial Surgery: A Single-Center Retrospective Analysis.Brain sciences · 2025Article
- Exoscope-Assisted Spine Surgery: A Systematic Review From Basic to Complex Pathologies.Cureus · 2025Review
- Performance and adaptability comparison between medical students and experienced neurosurgeons using a robotic exoscope with a head-mounted display.Journal of robotic surgery · 2025Article
- Optimizing Single-Position Prone Lateral Lumbar Interbody Fusion with Exoscopic Technology: A Review of Key Innovations.Journal of clinical medicine · 2025Review
- Exploring the clinical utility of postural outcome tools for back and neck pain clinical outcomes: a systematic scoping review.F1000Research · 2025Article
- Application of a head-mounted augmented reality display for visualization in convexity meningioma resection: A technical note.Surgical neurology international · 2025Article
- High-Definition 4K-3D Exoscope in Spine Surgery: A Single-Center Experience and Review of the Literature.Medicina (Kaunas, Lithuania) · 2024Review
- Exoscope and Supermicrosurgery: Pros and Cons of 3D Innovation in Lymphatic Surgery.Journal of clinical medicine · 2024Article
- Comparative analysis of exoscope-assisted spine surgery versus operating microscope: A systematic review.World neurosurgery: X · 2024Review
- Selective dorsal rhizotomy using a 3D high definition exoscope.Neurosurgical focus: Video · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe risk of musculoskeletal injuries (MSIs) increases over years of practice which may lead to career-ending among surgeons. Exoscopes represent a new generation of imaging systems that help surgeons operate in a more comfortable posture. This article aimed to assess advantages and limitations, especially ergonomics with a 3D exoscope in lumbar spine microsurgery versus an operating microscope (OM) to reduce MSIs.
methodsFrom March 2018 to May 2020, 90 patients with lumbar disc herniation undergoing a single-level minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) procedure were included. Forty-seven patients were operated with the assistance of the exoscope and 43 patients were operated with the assistance of the OM. Clinical data, magnification, and illumination were evaluated. In particular, the ergonomics of surgeons was evaluated by a questionnaire (subjective) and a rapid entire body assessment (REBA; objective).
resultsThe postoperative outcomes were reasonably well balanced between the two groups. The handling of the exoscope was comparable to that of the OM. The depth perception, image quality, and illumination of the exoscope were inferior to those of the OM in MIS-TLIF with long and deep approaches. The educational and training function of the exoscope was superior to that of the OM. Importantly, surgeons rated the ergonomics of the exoscope as very high on the questionnaire and the REBA to the OM (P = 0.017).
conclusionsThis study showed that the exoscope was a safe and effective alternative to the OM for assisting the MIS-TLIF procedure with the unique advantage of ergonomics to reduce musculoskeletal injuries.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.