Fluoroscopic exposure in modern spinal surgery. 2011

Patrick Fransen
Department of Neurosurgery, Clinique du Parc Léopold CHIREC, Brussels, Belgium. p.fransen@neurobrussels.be

The widespread use of minimally invasive and other spinal procedures raises concern about the peroperative radiation exposure to surgeon and patient. The authors noted the fluoroscopy time and the radiation dose, as read from the image amplifier, in 95 spinal procedures. The results of this prospective study varied widely between different operations. Percutaneous surgery was associated with more exposure than open surgery. For instance, the average radiation dose per pedicle screw was 3.2 times higher with percutaneous insertion than with an open approach. Therefore, efforts to reduce fluoroscopy time and radiation exposure should be made when using minimally invasive percutaneous surgical techniques. Preventive measures for the surgeon, such as lead aprons and gloves, thyroid shields, radioprotective glasses and staying away from the beam are recommended. Still from the surgeon's view-point, source inferior positioning of the image amplifier is indicated for the AP view, as well as monitoring of the radiation exposure. Finally, the difference in fluoroscopy time and radiation exposure between surgeons for the same procedure stresses the fact that peroperative radiation may be reduced by simple awareness and by training.

UI MeSH Term Description Entries
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011829 Radiation Dosage The amount of radiation energy that is deposited in a unit mass of material, such as tissues of plants or animal. In RADIOTHERAPY, radiation dosage is expressed in gray units (Gy). In RADIOLOGIC HEALTH, the dosage is expressed by the product of absorbed dose (Gy) and quality factor (a function of linear energy transfer), and is called radiation dose equivalent in sievert units (Sv). Sievert Units,Dosage, Radiation,Gray Units,Gy Radiation,Sv Radiation Dose Equivalent,Dosages, Radiation,Radiation Dosages,Units, Gray,Units, Sievert
D001863 Bone Screws Specialized devices used in ORTHOPEDIC SURGERY to repair bone fractures. Bone Screw,Screw, Bone,Screws, Bone
D005471 Fluoroscopy Production of an image when x-rays strike a fluorescent screen. Fluoroscopies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013123 Spinal Fusion Operative immobilization or ankylosis of two or more vertebrae by fusion of the vertebral bodies with a short bone graft or often with diskectomy or laminectomy. (From Blauvelt & Nelson, A Manual of Orthopaedic Terminology, 5th ed, p236; Dorland, 28th ed) Spondylodesis,Spondylosyndesis,Fusion, Spinal,Fusions, Spinal,Spinal Fusions,Spondylodeses,Spondylosyndeses
D016273 Occupational Exposure The exposure to potentially harmful chemical, physical, or biological agents that occurs as a result of one's occupation. Exposure, Occupational,Exposures, Occupational,Occupational Exposures
D017586 Diskectomy Excision, in part or whole, of an INTERVERTEBRAL DISC. The most common indication is disk displacement or herniation. In addition to standard surgical removal, it can be performed by percutaneous diskectomy (DISKECTOMY, PERCUTANEOUS) or by laparoscopic diskectomy, the former being the more common. Discectomy,Discectomies,Diskectomies
D054854 Vertebroplasty Procedures to repair or stabilize vertebral fractures, especially compression fractures accomplished by injecting BONE CEMENTS into the fractured VERTEBRAE.
D019637 Orthopedic Procedures Procedures used to treat and correct deformities, diseases, and injuries to the MUSCULOSKELETAL SYSTEM, its articulations, and associated structures. Orthopedic Surgery,Surgery, Orthopedic,Orthopedic Rehabilitation Surgery,Orthopedic Surgical Procedures,Orthopedic Procedure,Orthopedic Rehabilitation Surgeries,Orthopedic Surgeries,Orthopedic Surgical Procedure,Procedure, Orthopedic,Procedure, Orthopedic Surgical,Procedures, Orthopedic,Procedures, Orthopedic Surgical,Rehabilitation Surgeries, Orthopedic,Rehabilitation Surgery, Orthopedic,Surgeries, Orthopedic,Surgeries, Orthopedic Rehabilitation,Surgery, Orthopedic Rehabilitation,Surgical Procedure, Orthopedic,Surgical Procedures, Orthopedic

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