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.
Graphical abstract
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Change history
03 December 2019
Unfortunately, the first author surname was incorrectly published as ���Harrison Farber��� instead of ���Farber��� in original publication.
03 December 2019
Unfortunately, the first author surname was incorrectly published as ���Harrison Farber��� instead of ���Farber��� in original publication.
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Harrison Farber, S., Nayar, G., Desai, R. et al. Radiation exposure to the surgeon during minimally invasive spine procedures is directly estimated by patient dose. Eur Spine J 27, 1911–1917 (2018). https://doi.org/10.1007/s00586-018-5653-6
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DOI: https://doi.org/10.1007/s00586-018-5653-6