Comparison of Image Quality and Radiation Exposure From C-Arm Fluoroscopes When Used for Imaging the Spine

Prasarn, Mark L.; Coyne, Ellen; Schreck, Michael J.; Rodgers, Jamie D.; Rechtine, Glenn R.

doi:10.1097/brs.0b013e318294e27d

Cited by 16 publications

(9 citation statements)

References 10 publications

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“…When compared with four contemporary traditional IIs, it was found to have a 50% lower radiation energy emission. 27 Our results add to the unclear picture when comparing radiation output of mini C-arms with traditional IIs. It is, however, the largest study to date comparing the two machines.…”

Section: Discussionmentioning

confidence: 80%

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Mini C‐arm: faster, cheaper, safer?

Gieroba

Williams

Antoniou

et al. 2016

ANZ Journal of Surgery

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Section: Discussionmentioning

confidence: 80%

“…The GE OEC 9900 is a modern II. When compared with four contemporary traditional IIs, it was found to have a 50% lower radiation energy emission …”

Section: Discussionmentioning

confidence: 90%

Mini C‐arm: faster, cheaper, safer?

Gieroba

Williams

Antoniou

et al. 2016

ANZ Journal of Surgery

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“…There is an increased recent awareness of the need to minimise radiation risks during fluoroscopy and ongoing development of radiation reducing equipment with newer devices requiring lower emitted radiation to obtain even crisper images with more bone detail. 47) …”

Section: Discussionmentioning

confidence: 97%

Review of the Clinical Use of Fluoroscopy in Hand Surgery

2015

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Fluoroscopy is a commonly used tool in hand surgery. There have been recent advances in the technology and its clinical utilisation. Indications include assessment of joint and fracture fixation and stability, particularly when combined with minimally invasive techniques. Recent developments include surgeon operated mini C-arm image intensifiers. We present a review of the clinical utilisation of fluoroscopy in hand surgery including recent developments, Australian legislation, safety issues, strategies to reduce radiation exposure and clinical examples for imaging distal radius and scaphoid fracture fixation.

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“…Most surgeons consider the transforaminal puncture as the most critical and complicated step in this surgery, which is usually carried out under C-arm guidance. The surgeon needs to be familiar with the related lumbar spine anatomy, and well experienced with open surgery; otherwise, the frequency of exposure to radiation during the puncture increases significantly for both the patient and the surgeon (3)(4)(5). In addition, an inaccurate puncture may cause vessel, nerve, and abdominal organ injuries.…”

Section: Data Collection Processmentioning

confidence: 99%

Volume Navigation with Fusion of RealTime Ultrasound and CT Images to Guide Posterolateral Transforaminal Puncture in Percutaneous Endoscopic Lumbar Discectomy

Wang

2018

Pain Phys

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Background: The use of percutaneous endoscopic lumbar discectomy (PELD) is increasing in the treatment of lumbar disc herniations (LDH). Nerve and vessel injury may happen during the establishment of the transforaminal working channel. Also, there is usually exposure to intraop radiation when the C-arm is used to help establish the location of the transforaminal working channel. Objective: To evaluate the accuracy and safety of the volume navigation technique for guiding transforaminal puncture in cadaver and clinical patient treatment. Study Design: Cadaver experiment and comparative clinical research. Setting: Changhai Hospital, the Second Military Medical University. Method: Volume navigation guided transforaminal puncture was performed in 15 cadavers. The registration error, time of overall puncture, ultrasound (US) observed distance between needle tip and target (DNT), and puncture error were recorded. Clinical research was performed in 63 patients who had undergone PELD. Comparative research was done between 2 groups: Those who had transforaminal puncture carried out under C-arm guidance (n = 30), and those patients whose transforaminal puncture was carried out under volume navigation guidance (n = 33). Puncture times and frequency of fluoroscopy were recorded. Both groups were evaluated with Oswestry Disability Index (ODI), and visual analog scale (VAS) before surgery at 1, 3, and 6 months, and 1 year post-surgery. Results: In the cadaver experiment, mean registration error was 2.66 ± 1.10 mm; DNT 20.08 ± 1.32 mm; puncture error 2.91 ± 1.29 mm; overall time of puncture 22.10 ± 5.20 min. In the clinical patient research, puncture times and frequency of fluoroscopy were significantly lower in the volume navigation group compared with the C-arm group (P < 0.001). There were no significant differences between the 2 groups in ODI and VAS scores (P > 0.05) at different time points. Limitations: The correlation between the registration errors and the puncture errors requires further analysis. Also, due to the relatively small number of cases studied, additional cases need to be collected to obtain reliable results. Conclusion: The volume navigation technique can be used for PELD because it helps to guide percutaneous posterolateral transforaminal puncture accurately with reduced puncture times and intraop radiation. Key words: Lumbar disc herniation (LDH), ultrasound volume navigation (US VNav), percutaneous endoscopic lumbar discectomy (PELD), foramen, puncture

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Comparison of Image Quality and Radiation Exposure From C-Arm Fluoroscopes When Used for Imaging the Spine

Abstract: This is the first time that the spine image quality and radiation exposure of commonly used C-arm machines have been compared. The OEC was ranked the best, produced the best quality images, and had the least amount of radiation.

Cited by 16 publications

References 10 publications

Mini C‐arm: faster, cheaper, safer?

Mini C‐arm: faster, cheaper, safer?

Review of the Clinical Use of Fluoroscopy in Hand Surgery

Volume Navigation with Fusion of RealTime Ultrasound and CT Images to Guide Posterolateral Transforaminal Puncture in Percutaneous Endoscopic Lumbar Discectomy

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