• Alexander J Schupper, Eugene I Hrabarchuk, Lily McCarthy, and Constantinos G Hadjipanayis.
• Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address: alexander.schupper@mountsinai.org.
• World Neurosurg. 2023 Jul 1; 175: e1220e1225e1220-e1225.

BackgroundMusculoskeletal disorders are common among surgeons, and affect most neurosurgeons over the course of their career. Although all subspecialist neurosurgeons may be affected by physical strain, spine surgeons and skull base surgeons have a high propensity for workplace injury as a result of long procedures with repetitive movements in strained physical positions.MethodsIn this review, the prevalence of musculoskeletal disorders in neurosurgery, the state of innovation to improve ergonomics in the operating room for neurosurgeons, and potential limitations in advancing technology with the goal of maximizing neurosurgeon longevity are discussed.ResultsInnovations such as robotics, the exoscope, and handheld devices with more degrees of freedom have allowed surgeons to maneuver instruments without exerting excessive effort, all while maintaining neutral body positioning, avoiding joint and muscle strain.ConclusionsAs new technology and innovation in the operating room develop, there has been a larger emphasis placed on maximizing surgeon comfort and neutral positioning, by minimizing force exertion and fatigue.Copyright © 2023 Elsevier Inc. All rights reserved.

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