Faculty Collaboration Database

Radiation exposure to the surgeon during minimally invasive spine procedures is directly estimated by patient dose. Eur Spine J 2018 Aug;27(8):1911-1917

Date

06/28/2018

Pubmed ID

29948320

DOI

10.1007/s00586-018-5653-6

Scopus ID

2-s2.0-85048279856 (requires institutional sign-in at Scopus site)   17 Citations

Abstract

PURPOSE: Radiation exposure is a necessary component of minimally invasive spine procedures to augment limited visualization of anatomy. The surgeon's exposure to ionizing radiation is not easily recognizable without a digital dosimeter-something few surgeons have access to. The aim of this study was to identify an easy alternative method that uses the available radiation dose data from the C-arm to accurately predict physician exposure.

METHODS: The senior surgeon wore a digital dosimeter during all minimally invasive spine fusion procedures performed over a 12-month period. Patient demographics, procedure information, and radiation exposure throughout the procedure were recorded.

RESULTS: Fifty-five minimally invasive spine fusions utilizing 330 percutaneous screws were included. Average radiation dose was 0.46 Rad/screw to the patient. Average radiation exposure to the surgeon was 1.06 ± 0.71 μSv/screw, with a strong positive correlation (r = 0.77) to patient dose. The coefficient of determination (r²) was 0.5928, meaning almost two-thirds of the variability in radiation exposure to the surgeon is explained by radiation exposure to the patient.

CONCLUSIONS: Intra-operative radiation exposure to the patient, which is easily identifiable as a continuously updated fluoroscopic monitor, is a reliable predictor of radiation exposure to the surgeon during percutaneous screw placement in minimally invasive spinal fusion surgery and therefore can provide an estimate of exposure without the use of a dosimeter. With this, a surgeon can better understand the magnitude of their exposure on a case-by-case basis rather than on a quarterly basis, or more likely, not at all. These slides can be retrieved under Electronic Supplementary Material.

Author List

Harrison Farber S, Nayar G, Desai R, Reiser EW, Byrd SA, Chi D, Idler C, Isaacs RE

Author

Rupen Desai MD Assistant Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Female
Fluoroscopy
Humans
Male
Middle Aged
Minimally Invasive Surgical Procedures
Occupational Exposure
Prospective Studies
Radiation Dosage
Radiation Dosimeters
Radiation Exposure
Spinal Fusion
Surgeons