Orthopedic Surgery is Dangerous…for the Surgeon!

In a recent survey of the current and 12 former presidents of the Scoliosis Research Society (SRS):

• seven of the 13 had rotator cuff pathologies (one bilateral);
• five had lumbar pathologies, including three cases of herniated nucleus pulposus, two of which were treated surgically;
• three reported having had carpometacarpal joint arthritis, one resulting in retirement;
• one reported lateral epicondylitis;
• a case of carpal tunnel syndrome required bilateral surgery; and
• one suffered an acute distal phalanx fracture during surgery.

That’s a lot of workplace injuries. Is this small sample an anomaly? No, according to Baron Lonner, M.D., Professor of Orthopaedic Surgery at Mount Sinai Hospital and Director, Scoliosis and Spine Associates in New York City, who presented these harsh stats in mid-March at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS).

Dr. Lonner was also one of the researchers in a larger survey, “Musculoskeletal Disorders Among Spine Surgeons: Results of a Survey of the Scoliosis Research Society Membership” led by Joshua D. Auerbach, M.D., in 2011. Among 561 respondents (of 904 SRS members), that earlier survey found:

“The most common self-reported diagnoses included neck pain/strain/spasm (38%, 215/561), lumbar disc herniation/radiculopathy (31%, 172/561), cervical disc herniation/radiculopathy (28%, 155/561), rotator cuff disease (24%, 134/561), varicose veins or peripheral edema (20%, 112/561), and lateral epicondylitis (18%, 99/561). For lumbar disc disease, 7.1% (40/561 × 100) and for cervical disc disease, 4.6% (26/561 × 100) of spine surgeons underwent surgery.”

Also, “19.1% reported instrumentation-related injury (most commonly superficial cuts/abrasion).”

There were and are contributing factors, the study said. “Among active spine surgeons, multiple linear regression analysis revealed that total caseload correlated with neck pain (P = 0.01) and lower extremity edema (P = 0.03), while the number of deformity cases correlated with wrist pain (P = 0.003) and hand pain (P = 0.03). Age was correlated with shoulder (P = 0.03), elbow (P = 0.04), and hand pain (P = 0.02). Number of years in practice did not correlate with MSDs [musculoskeletal disorder].”

Another likely factor: the pressure to work fast. Both Medicare and private insurance put the entire operating room staff, and especially surgeons, under financial pressure to stay on schedule.