Work-related musculoskeletal disorders among endoscopic transsphenoidal surgeons: a systematic review of prevalence and ergonomic interventions

Endoscopic transsphenoidal surgery is a surgical technique introduced in the last 20 years for the treatment of skull base pathologies and, in particular, pituitary tumours. Although the prevalence of work-related musculoskeletal disorders is usually significantly higher in endoscopists and minimally invasive surgeons compared to other surgical and medical specialties, reviews on the prevalence of disorders among neurosurgeons dedicated to endoscopic transsphenoidal surgery are not available. This article performs a systematic review to identify the work-related musculoskeletal disorders among transsphenoidal neurosurgeons, their prevalence and the ergonomic interventions proposed to reduce risk factors and prevent disorders. The results show that the ergonomics of transsphenoidal neurosurgeons is an under-investigated topic. Indeed, specific prevalence data are not available. In addition, only a few papers suggest interventions and guidelines, but without objective assessment of the outcomes to confirm the ergonomic benefit. Based on these gaps in the literature, a future research agenda is proposed.