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Radiation Exposure and Avoidance in Minimally Invasive Spine Surgery

  • Bryan S. Lee
  • Dominic W. Pelle
  • Nicholas R. Arnold
  • Thomas E. MrozEmail author
Chapter

Abstract

The advent of minimally invasive spine surgery (MIS or MISS) heralds an important milestone in the surgical management of spinal disorders. MIS provides the modern spine surgeon the ability to treat spine pathology in a precise, less morbid manner when compared to open procedures. The benefits of MIS over open procedures include, but are not limited to, decreased blood loss, decreased infection rates, and decreased hospital length of stay. These benefits of MIS coexist with the burden of an increased reliance on radiographic imaging in the operating theater. Radiography in MIS can produce significant amounts of radiation, placing both the surgeon and patient at risk. Efforts to limit radiation exposure in MIS stem from a basic understanding of the physical nature of ionizing radiation and its effects on living tissue. Although the quantity of radiation produced in various MIS procedures varies in the literature, a surgeon’s hands and thyroid gland may represent structures consistently at risk. Techniques to limit radiation exposure include preoperative considerations, such as prudently planning when imaging is necessary during a case, and intraoperative adjustments such as appropriately positioning the radiation source in relation to the patient and surgeon. Knowledge of these techniques allows spine surgeons to effectively perform MIS while simultaneously reducing radiation exposure.

Keywords

Ionizing radiation Minimally invasive spine surgery MIS surgery Radiation exposure 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Bryan S. Lee
    • 1
    • 2
    • 3
  • Dominic W. Pelle
    • 4
    • 5
  • Nicholas R. Arnold
    • 6
  • Thomas E. Mroz
    • 7
    • 8
    • 9
    Email author
  1. 1.Department of NeurosurgeryCleveland ClinicClevelandUSA
  2. 2.Center for Spine HealthCleveland ClinicClevelandUSA
  3. 3.Cleveland Clinic Lerner College of Medicine of Case Western Reserve UniversityClevelandUSA
  4. 4.Department of NeurosurgeryCleveland ClinicClevelandUSA
  5. 5.Center for Spine HealthCleveland ClinicClevelandUSA
  6. 6.Department of Orthopaedic SurgeryCleveland Clinic FoundationClevelandUSA
  7. 7.Department of NeurosurgeryCleveland ClinicClevelandUSA
  8. 8.Center for Spine HealthCleveland ClinicClevelandUSA
  9. 9.Department of Orthopaedic SurgeryCleveland Clinic FoundationClevelandUSA

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