Evidence map›Paper›PMID 42022143›Full record

ArticleBrain & spine2026

Comparing the ergonomic aspects of the exoscope and microscope in neurosurgery using motion sensors.

Alaa Al Nwelati, Martin Misch, Anna-Gila Karbe, Denny Chakkalakal, Thomas Picht, Peter Vajkoczy, Judith Rösler, Julia Onken

Abstract read
In one paragraph

Article in Brain & spine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Alaa Al NwelatiDepartment of Neurosurgery, Charité Universitätsmedizin, Berlin, Germany.
Martin MischDepartment of Neurosurgery, Charité Universitätsmedizin, Berlin, Germany.
Anna-Gila KarbeDepartment of Neurosurgery, Charité Universitätsmedizin, Berlin, Germany.
Denny ChakkalakalDepartment of Neurosurgery, Charité Universitätsmedizin, Berlin, Germany.
Thomas PichtDepartment of Neurosurgery, Charité Universitätsmedizin, Berlin, Germany.
Peter VajkoczyDepartment of Neurosurgery, Charité Universitätsmedizin, Berlin, Germany.
Judith RöslerDepartment of Neurosurgery, Uniklinik Düsseldorf, Düsseldorf, Germany.
Julia OnkenDepartment of Neurosurgery, Charité Universitätsmedizin, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Ergonomic improvement for neurosurgeons is essential in reducing musculoskeletal disorders, particularly during prolonged procedures. Traditional microscopes often limit the range of motion, forcing surgeons into uncomfortable positions, particularly in cases involving angulated or narrow anatomy. Research question: This study compares neurosurgeons' posture and handling of the exoscope versus the microscope evaluating its ergonomic aspects. Methods: 26 cases were operated using a microscope (Zeiss, Jena, Germany) and 29 using an exoscope (Olympus, Tokyo, Japan). Data included task load index, camera and ocular adjustments, as well as subjective and objective assessments of posture. Sensor-based movement measurements were available for 18 cases, of which 8 were operated using the exoscope and were used to evaluate the surgeon's neck posture. Results: The task load index showed lower means when using the exoscope without significant differences. Camera adjustments were, on average, more frequent when using the exoscope (35.6 vs 26.9; p = 0.153). Subjective assessment indicated better body reclination and lateral bending posture with the exoscope (p < 0.001). Sensor data revealed angles of neck inclination, reclination, and lateral bending mostly below 20° across both modalities, without statistically significant differences. Conclusion: The exoscope group reported lower fatigue scores and subjectively milder body posture angles, suggesting ergonomic benefits, with no significant differences in the measured neck posture. The higher frequency of camera adjustments with the exoscope, combined with lower fatigue scores, highlights its potential ergonomic advantages due to increased range of motion, which are likely to improve further with ongoing technical refinements and growing user experience.

Identifiers

PMID42022143
PMCPMC13097000

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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.