Zonshayn S, Coppola C, Lawrence JP. Energy Consumption and Substrate Utilization During Spinal Surgery.
J Am Acad Orthop Surg Glob Res Rev 2024;
8:01979360-202402000-00009. [PMID:
38354213 PMCID:
PMC11136513 DOI:
10.5435/jaaosglobal-d-23-00092]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 11/14/2023] [Accepted: 12/18/2023] [Indexed: 02/16/2024]
Abstract
INTRODUCTION
This study aims to measure surgeon physiologic stress and energy expenditure during adult spine surgery. Energy expenditures were assessed based on patient BMI, lead use, instrumentation/intraoperative navigation, primary/revision surgeries, tranexamic acid (TXA) use, and anatomic region involved.
METHODS
The senior author wore a heart rate (HR) monitor and triaxial accelerometer during spinal surgeries, providing assessments of mean HR, maximum HR, calories consumed/minute, and calories as measured by a Polar device (P calories) and Fitbit device (F calories).
RESULTS
One hundred sixty-two surgeries were included. Median patient age was 62 years. Median BMI was 29.02. Significant differences existed for BMI and estimated blood loss (P < 0.05). TXA use had a significant effect on case time, estimated blood loss, P calories, F calories, and Kcal/min (P < 0.05). Instrumentation use was significant for all variables (P < 0.05), except for mean HR and Kcal/min (P > 0.05). Lead use did not have a significant effect on max HR, P calories, F calories, and Kcal/min (P > 0.05). Navigation use was associated with significant differences for every variable tested (P ≤ 0.05). Differences were observed between primary and revision surgeries for case time, estimated blood loss, and F calories (P < 0.05).
CONCLUSIONS
In spinal surgery, the use of navigation, instrumentation use, TXA use, and performing revision surgeries were associated with increased energy expenditure and can potentially increase surgeon fatigue.
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