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Strahlenexposition bildgestützte Navigationssysteme vs. konventionelle Technik

Experimentelle Untersuchung

Intraoperative ionising radiation in 3D-based computer-navigated procedures vs. 2D fluoroscopy

An experimental comparison

  • Leitthema
  • Published:
Trauma und Berufskrankheit

Zusammenfassung

Der steigende Einsatz von Röntgengeräten im OP (Operationssaal), v. a. bei minimalinvasiven Eingriffen, wirft Fragen bezüglich der Möglichkeiten der Strahlenreduktion sowie der Risiken für das Personal auf. Mittels eines männlichen Rando-Alderson-Phantoms wurden Dosismessungen durchgeführt. Es wurden 4 Operationstypen analysiert: die konventionelle sowie die 3D-navigierte dorsale Spondylodese der Lendenwirbelsäule und die konventionelle sowie die 3D-navigierte perkutane Verschraubung der Sakroilikalfuge (SI-Fuge). Die Effektivdosis der konventionellen dorsalen Spondylodese ist 12-mal höher als die der navigierten Operation. Für SI-Verschraubungen kann durch die navigierten Verfahren eine Reduktion der Strahlenbelastung um den Faktor 5 erzielt werden. Somit senkt der Einsatz computernavigierter Verfahren die Effektivdosis für Patienten und damit auch die Belastung für das Personal erheblich.

Abstract

The increasing use of fluoroscopy-based surgical procedures, especially in minimally invasive surgery, and the associated exposure to radiation raises questions about reduction possibilities as well as potential risks for OR personnel. Dose measurements were performed with a male Rando-Alderson-phantom. Four types of operation where analysed: Standard posterior stabilization of the lumbar spine, 3D-navigated posterior stabilization of the lumbar spine, standard percutaneous transsacral screw stabilization for sacroiliac joint injuries and 3D-navigated percutaneous transsacral screw stabilization for sacroiliac joint injuries The effective dose in standard spine surgery using 2D fluoroscopy is more than twelve-fold higher than in navigated operations. For the sacroiliac joint the effective dose is nearly five-fold higher for non-navigated operations. The use of computer-assisted methods reduces the patient’s effective dose, thereby also reducing exposure of personnel significantly.

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Correspondence to F. Gebhard.

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Die Studie wurde durch die Siemens AG Healthcare Sector (Erlangen, Deutschland) unterstützt.

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Gebhard, F., Banckwitz, R. & Kraus, M. Strahlenexposition bildgestützte Navigationssysteme vs. konventionelle Technik. Trauma Berufskrankh 11, 162–166 (2009). https://doi.org/10.1007/s10039-009-1497-y

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Navigation