Computed Tomography Intraoperative Navigation in Spinal Surgery: Assessment of Patient Radiation Exposure in Current Practices

Article Figures & Data

Table 1

Study groups by surgical indication (N = 101).

Surgical Indications	n
Spinal deformities	58
Posterior thoracolumbar or lumbar fusion
Idiopathic scoliosis	25
Degenerative scoliosis	21
Transpedicular osteotomy or pedicle subtraction osteotomy
Kyphoscoliosis	10
Proximal junctional kyphosis	2
Degenerative Diseases	31
Lumbar fusion
Anterior lumbar interbody fusion	3
Transforaminal lumbar interbody fusion	21
Lumbar arthrodesis	3
Spinal revision	1
Thoracic herniated disc	2
Decompression without instrumentation	1
Vertebral fractures	12
Vertebroplasty	8
Kyphoplasty	4

Table 2

Patient demographics.

Demographic	Spinal Deformities	Degenerative Diseases	Vertebral Fractures	Total Population	P Value
Gender, n
Women	50	19	7	76	NA
Men	8	12	5	25
Age, y, mean (range)	46 (13–79)	59 (16–84)	72 (51–86)	56 (13–86)	<0.01
Body mass index, kg/m², mean (range)	23.4 (14.9–36.9)	26.3 (20–37)	27.3 (21.1–36.5)	24.8 (14.9–36.9)	<0.01
Vertebral levels treated, mean (range)	9 (4–16)	2 (1–4)	1 (1–2)	NA	<0.01

Table 3

Radiation exposure data across the groups.

Radiation Oucome Measure	Spinal Deformity	Degenerative Diseases	Vertebral Fractures
Exposure time/acquisition, s	14.9 ± 2.3 (8.6–24.6)	11.8 ± 1.4 (9.4–15.1)	11.8 ± 1.2 (10.4–15)
Acquisition length, cm	29.3 ± 5.7 (13.8–53.6)	21.8 ± 3.6 (15.7–30)	21.8 ± 2.9 (18.3–29.7)
CTDI_vol /acquisition, mGy	20.1 ± 6.9 (9.1–50.6)	24.3 ± 6.1 (17.1–50.6)	24.4 ± 4.6 (17.8–33.9)
DLP per single scan, mGy·cm	674.9 ± 233.7 (283.7–1845.8)	656.8 ± 187.3 (409.1–1269.2)	649.4 ± 80.2 (529.2–797.2)
Effective dose/acquisition, mSv	10.1 ± 3.5 (4.3–27.7)	9.8 ± 2.8 (6.1–19.0)	9.7 ± 1.2 (7.9–12)
Total DLP per patient, mGy·cm	1175.3 ± 623.6 (436.4–3393.1)	762.7 ± 275.6 (409.1–1551.7)	649.3 ± 80.2 (529.16–797.3)
Radiation dose received by 1 patient, mSv	17.6 ± 9.3 (6.5–50.9)	11.4 ± 4.1 (6.1–23.3)	9.7 ± 1.2 (7.9–12)

Abbreviations: CTDI_vol, Computed tomography dose index; DLP, dose-length product.
Note: Data presented as mean ± SD (range).