Fluoroscopic Radiation Exposure to Operating Room Personnel in Spinal Surgery

Fan, Guoxin; Zhao, Shuang; He, Shisheng; Gu, Xia; Guan, Xiaofei

doi:10.1097/bsd.0000000000000083

Cited by 6 publications

(7 citation statements)

References 5 publications

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“…1,13,15,16 During open procedures, a clear orientation is provided by the anatomical landmarks of the vertebrae, which results in less radiation exposure to the surgeon, patients and operating room team, compared to minimally invasive surgery (MIS) techniques. 1,5 In percutaneous procedures, anatomical landmarks are lacking, and longer radiation exposure times are required compared to open procedures. The greater exposure of patients and operating room staff to radiation, and the associated risks, 1,7,8,15 have prompted the development of new technologies for intraoperative image acquisition and intraoperative image navigation, such as computed tomography, magnetic ressonance imaging and other techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, in the percutaneous setting, the anatomical landmarks are lacking, and this requires time-consuming fluoroscopy guidance. [4][5][6][7][8] The patient's exposure is limited to one procedure, but the surgeon and operating room staff are repeatedly exposed to radiation, during multiple procedures. [8][9][10][11] The most common equipment used in intraoperative image acquisition is the c-arm, due to its capacity to present real time images.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Exposure to Radiation During Percutaneous Transpedicular Procedures, Using Three Fluoroscopic Techniques

et al. 2017

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Objective: To compare radiation exposure to the surgeon, patient and radiation technician during percutaneous access of the vertebral pedicle, using three different fluoroscopic imaging set up. Methods: Percutaneous access in pedicle T9-L5 of nine adult male cadavers using three different fluoroscopic set ups: standard C-arm, C-arm with L-arm, and the biplanar technique. The radiation dose exposure of the surgeon, radiation technician, and cadaver were measured using dosimeter in each procedure and in real time. Results: The radiation dose absorbed by the surgeon was higher when using the standard C-arm fluoroscopic technique than when using the C-arm with L-arm or the biplanar technique. Conclusions: The use of the C-arm with L-arm, or the biplanar fluoroscopic technique, for percutaneous access to the vertebral pedicle, reduces the radiation exposure of the surgeon compared to the standard C-arm fluoroscopic technique.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of Exposure to Radiation During Percutaneous Transpedicular Procedures, Using Three Fluoroscopic Techniques

et al. 2017

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“…[22][23][24] These values can be used for the subset of population whose specific organs are exposed to radiation rather than the whole body. The maximum permissible exposure recommended is 150 mSv for the eye and 500 mSv for the skin as well as the extremities.…”

Section: Discussionmentioning

confidence: 99%

“…Using our spinal locators, the maximum number of MIS-TLIF surgery for 1 surgeon per year was 8517 for the arm, 5285 for the finger, 6473 for the whole body, 7142 for the eye (protected), and 952 for the eye (unprotected). 30 Maybe it was due to its proximity to the beam source or the direct delivery of radiation exposure, 24 but the inconvenient truth was that surgeons did not use leaded gloves in MIS surgeries due to the inconvenience of operating. If the surgeon wear lead mask to protect the eyes, he could only operate no more than 5285 MIS-TLIF surgeries using our spinal locators.…”

Section: Discussionmentioning

confidence: 99%

Radiation Exposure to Surgeon in Minimally Invasive Transforaminal Lumbar Interbody Fusion With Novel Spinal Locators

Fan

Fu²,

Gu³

et al. 2015

Journal of Spinal Disorders &Amp; Techniques

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“…The damage of radiation exposure induced by repeated fluoroscopy in transforaminal endoscopic surgery to patients and surgeons could not be ignored in clinics. The International Commission on Radiological Protection (ICRP) had recommended radiation limits per year for professionals specialized body tissues and organs[ 9 ]. Ahn et.al [ 10 ] detected the radiation dose for neck, chest, arm and hands of spine surgeons in 30 cases of transforaminal endoscopic surgery, which showed the radiation dose of neck, chest, arm and hands (left and right) were 0.0863 mSv, 0.1890 mSv, 0.0506 mSv, 0.8050 mSv and 0.7363 mSv respectively.…”

Section: Discussionmentioning

confidence: 99%

Puncture Reduction in Percutaneous Transforaminal Endoscopic Discectomy with HE’s Lumbar LOcation (HELLO) System: A Cadaver Study

et al. 2015

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BackgroundPercutaneous transforaminal endoscopic discectomy (PTED) usually requires numerous punctures under X-ray fluoroscopy. Repeated puncture will lead to more radiation exposure and reduce the beginners' confidence.ObjectiveThis cadaver study aimed to investigate the efficacy of HE’s Lumbar Location (HELLO) system in puncture reduction of PTED.Study designCadaver study.SettingComparative groups.MethodsHELLO system consists of self-made surface locator and puncture locator. One senior surgeon conducted the puncture procedure of PTED on the left side of 20 cadavers at L4/L5 and L5/S1 level with the assistance of HELLO system (Group A). Additionally, the senior surgeon conducted the puncture procedure of PTED on the right side of the cadavers at L4/L5 and L5/S1 level with traditional methods (Group B). On the other hand, an inexperienced surgeon conducted the puncture procedure of PTED on the left side of the cadavers at L4/L5 and L5/S1 level with the assistance of our HELLO system (Group C).ResultsAt L4/L5 level, there was significant difference in puncture times between Group A and Group B (P<0.001), but no significant difference was observed between Group A and Group C (P = 0.811). Similarly at L5/S1 level, there was significant difference in puncture times between Group A and Group B (P<0.001), but no significant difference was observed between Group A and Group C (P = 0.981). At L4/L5 level, there was significant difference in fluoroscopy time between Group A and Group B (P<0.001), but no significant difference was observed between Group A and Group C (P = 0.290). Similarly at L5/S1 level, there was significant difference in fluoroscopy time between Group A and Group B (P<0.001), but no significant difference was observed between Group A and Group C (P = 0.523). As for radiation exposure, HELLO system reduced 39%-45% radiation dosage when comparing Group A and Group B, but there was no significant difference in radiation exposure between Group A and Group C whatever at L4/L5 level or L5/S1 level (P>0.05). There was no difference in location time between Group A and Group B or Group A and Group C either at L4/L5 level or L5/S1 level (P>0.05).LimitationsSmall-sample preclinical study.ConclusionHELLO system was effective in reducing puncture times, fluoroscopy time and radiation exposure, as well as the difficulty of learning PTED. (2015-RES-127)

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Fluoroscopic Radiation Exposure to Operating Room Personnel in Spinal Surgery

Cited by 6 publications

References 5 publications

Comparison of Exposure to Radiation During Percutaneous Transpedicular Procedures, Using Three Fluoroscopic Techniques

Comparison of Exposure to Radiation During Percutaneous Transpedicular Procedures, Using Three Fluoroscopic Techniques

Radiation Exposure to Surgeon in Minimally Invasive Transforaminal Lumbar Interbody Fusion With Novel Spinal Locators

Puncture Reduction in Percutaneous Transforaminal Endoscopic Discectomy with HE’s Lumbar LOcation (HELLO) System: A Cadaver Study

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