A Real-Time Ergonomic Coaching System for Neurosurgeons Using Virtual Reality and Machine Learning-Based Posture Analysis

Background: Musculoskeletal disorders continue to affect neurosurgeons with the prevalence of work-related musculoskeletal disorders exacerbated by long hours of static postures in performing delicate and precise surgeries. Ergonomics training, despite its increasing emphasis, is still not adequately integrated within the structure of neurosurgical education. Objective: In this paper, we present to you the Automated Ergonomics Coaching System (AECS)- a virtual reality-based training platform with Artificial Intelligence-powered pose estimation that enables real-time feedback in creating ergonomic awareness during neurosurgical simulations. Methods: Twenty-four neurosurgical residents were randomly divided into two groups, an AECS group and a control group. All participants underwent three sessions of simulation training on spine surgery. The quantification of posture deviations was carried out by the model pose and was supplemented by pre- and post-usability questionnaires to assess usability and ergonomics awareness Results: Though not proven statistically, there was a difference in the ergonomic error rates between the two groups (p=0.278). AECS members showed steady progress from one trial to the next. They had good posture check, were more confident in their ability to correct ergonomics, and gave the system high marks for usability. A large percentage, 73.91%, said that they now have better knowledge as to the strains that come with postures. Conclusions: AECS shows potential as a practical, feedback-rich training system that enhances ergonomic posture in surgical education. Real-time pose estimation and interactive guidance support a safer, more sustainable learning pathway for surgeons. Future work will explore long-term retention and cross-institutional validation.