Does Less Invasive Spine Surgery Result in Increased Radiation Exposure? A Systematic Review

Yu, Elizabeth; Khan, Safdar N.

doi:10.1007/s11999-014-3503-3

Cited by 104 publications

(66 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As the minimally invasive technique has been developed and widely used in spine surgery, the use of C-arm fluoroscopy is being increased to improve the accuracy of equipment, and the number of medical staffs experiencing complications due to low-dose ionizing radiation increases as well. 8 There are a number of studies reporting significant exposure of radiation in MISS, 3,[9][10][11] as well as a study reporting a 5-fold increase in the incidence of lifetime cancer of orthopedic surgeons compared to general practitioners. 12 Wearing protector is the most common protection method, but it has an adverse effect on the human body because the fatigue of the operator is increased due to its heavy weight.…”

Section: Discussionmentioning

confidence: 99%

A New Shielding Curtain for Protection of Intraoperative Radiation During Minimally Invasive Spine Surgery

Park

et al. 2020

Neurospine

View full text Add to dashboard Cite

Objective: Gradually increasing number of minimally invasive spine surgery (MISS), there is an increasing risk of radiation exposure to medical personnel during the surgery. We measured the radiation exposure of the operating room personnel during MISS, tried to find the riskiest person, and checked the effectiveness of a new lead-composite shielding curtain. Methods: Radiation exposure of medical staffs (operator, first assistant, anesthesiologist, and scrub nurse) involved in MISS procedures of 35 patients without shielding curtain (nonshield group) and 35 patients with shielding curtain (shield group). The shielding curtain had 0.25-mm nominal lead equivalent and was mounted on 2 frame bars fixed on the operating table. Results: In the nonshield group, radiation exposure was significantly higher in the order of operator > first assistant > scrub nurse > anesthesiologist (p < 0.001) during both anteroposterior (AP) and lateral views. In the shield group, the radiation exposure of the operator and the scrub nurse decreased significantly by 94.1% and 76.4% in AP view (p < 0.001), and by 96.3% and 73.9% in lateral view (p < 0.001), respectively. Conclusion: Since the radiation dose of the operator was highest in a C-arm-guided MISS, there is a high priority need to protect the operator from the radiation exposure. The shielding curtain could most effectively reduce the radiation exposure of the operator.

show abstract

Section: Discussionmentioning

confidence: 99%

A New Shielding Curtain for Protection of Intraoperative Radiation During Minimally Invasive Spine Surgery

Park

et al. 2020

Neurospine

View full text Add to dashboard Cite

show abstract

“…3,8,40 One potential advantage of robotic spinal instrumentation is to minimize reliance on intraoperative fluoroscopy. Findings for FT in the Mazor robot were variable, ranging from 1.3 seconds to 34 seconds per screw, probably due to surgeon variability.…”

Section: Discussionmentioning

confidence: 99%

Current applications of robotics in spine surgery: a systematic review of the literature

Joseph

Smith

2017

Neurosurgical Focus

171

144

View full text Add to dashboard Cite

OBJECTIVESurgical robotics has demonstrated utility across the spectrum of surgery. Robotics in spine surgery, however, remains in its infancy. Here, the authors systematically review the evidence behind robotic applications in spinal instrumentation.METHODSThis systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Relevant studies (through October 2016) that reported the use of robotics in spinal instrumentation were identified from a search of the PubMed database. Data regarding the accuracy of screw placement, surgeon learning curve, radiation exposure, and reasons for robotic failure were extracted.RESULTSTwenty-five studies describing 2 unique robots met inclusion criteria. Of these, 22 studies evaluated accuracy of spinal instrumentation. Although grading of pedicle screw accuracy was variable, the most commonly used method was the Gertzbein and Robbins system of classification. In the studies using the Gertzbein and Robbins system, accuracy (Grades A and B) ranged from 85% to 100%. Ten studies evaluated radiation exposure during the procedure. In studies that detailed fluoroscopy usage, overall fluoroscopy times ranged from 1.3 to 34 seconds per screw. Nine studies examined the learning curve for the surgeon, and 12 studies described causes of robotic failure, which included registration failure, soft-tissue hindrance, and lateral skiving of the drill guide.CONCLUSIONSRobotics in spine surgery is an emerging technology that holds promise for future applications. Surgical accuracy in instrumentation implanted using robotics appears to be high. However, the impact of robotics on radiation exposure is not clear and seems to be dependent on technique and robot type.

show abstract

“…Werden intraoperativ gewonnene 3-D-Röntgen-oder CT-Datensätze verwendet, ist die direkte Kopplung mit dem Navigationsgerät möglich. Mit diesem Verfahren lässt sich die Strahlenbelastung für Patient und Personal um bis zu 60 % vermindern [21,22].…”

Section: Navigationunclassified

Bildgebung für den Orthopäden und Unfallchirurgen

Keil¹,

Franke²,

Grützner³

2018

Orthopädie und Unfallchirurgie up2date

View full text Add to dashboard Cite

Does Less Invasive Spine Surgery Result in Increased Radiation Exposure? A Systematic Review

Abstract: Background Radiation exposure to patients and spine surgeons during spine surgery is expected.

Cited by 104 publications

References 25 publications

A New Shielding Curtain for Protection of Intraoperative Radiation During Minimally Invasive Spine Surgery

A New Shielding Curtain for Protection of Intraoperative Radiation During Minimally Invasive Spine Surgery

Current applications of robotics in spine surgery: a systematic review of the literature

Bildgebung für den Orthopäden und Unfallchirurgen

Contact Info

Product

Resources

About