RT Journal Article
SR Electronic
T1 Fluoroscopic Cranial Radiation Exposure in Spine Surgery: A Prospective Single-Center Evaluation in Operating Room Personnel
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 28
OP 32
DO 10.14444/6004
VO 13
IS 1
A1 MOHAMMAD, LAILA MALANI
A1 MESSEGEE, JAMES
A1 CHOHAN, M. OMAR
A1 TAYLOR, CHRISTOPHER L.
YR 2019
UL https://www.ijssurgery.com/content/13/1/28.abstract
AB Background: Cranial radiation exposure during instrumented spine surgery is not well documented. We set out to measure this risk to the patient, surgeon, surgical resident, and scrub technician during these procedures.Methods: Forty-seven individuals were enrolled during a 1.5-year period between October 2014 and March 2016 at the University of New Mexico Department of Neurosurgery. Radiation doses were obtained through electronic dosimeters placed on the surgical cap over the temporal scalp (bilaterally on surgeon and resident assist, unilaterally on surgical scrub on the side facing radiation source) and on the midline of the patient's exposed cranium.Results: Of the 47 procedures, 39 (83%) were open and 8 (17%) were minimally invasive or percutaneous instrumented procedures. A total of 91 motion segments were treated, with a mean of 1.9 levels per case (57% lumbosacral, 34% cervical, and 2.1% thoracic). Total fluoroscopic time was 12.9 minutes. Mean dose per case (mrem/case) was calculated for the spine surgeon (1.4), resident assist (1.4), surgical scrub (1.2), and the patient (3.6). All doses were within federal safety guidelines. A spine surgeon would need to perform more than 1400 cases per year to reach the current federal maximum permissible dose for head exposure.Conclusions: There was no difference in cranial radiation exposure between operating room staff during spine surgeries. Moreover, the doses measured at the cranium were within national safety limits. Current protective technologies have significantly reduced the amount of ionizing radiation exposure during routine spine procedures; however, changes in behavior or equipment may further reduce radiation exposure to health care workers.Clinical Relevance: Radiation exposure to patients and hospital staff remains a major concern in the practice of modern spine surgery. Cranial exposure remains the only established environmental risk factor for brain tumors, such as gliomas and meningiomas. Our study shows that all those exposed to radiation during spine surgery had cranial doses well within the national safety limits.