302 - Radiation Exposure to the Surgeon During Minimally Invasive Spine Proc...

Oral Posters: Cervical

Presented by: R. Isaacs - View Audio/Video Presentation (Members Only)


R. Isaacs(1)

(1) Duke University, Neurosurgery, Durham, NC, United States


Introduction: Radiation exposure during minimally invasive spine procedures is a potential health threat to physicians, staff, and patients alike. While the patient is exposed only at the time of their procedure, physicians and other ancillary staff are bombarded with scatter radiation during each intervention throughout their career. While the ionizing radiation exposure to the patient is easily found, as it is recorded and displayed on the fluoroscope screen throughout the intervention, the amount of exposure that the physician is subjected to is not as easily recognized. Aims and

Objectives: Herein we measured radiation exposure to the patient and the physician during percutaneous screw placement to determine if physician exposure can be predicted by that to the patient.

Methods: The senior surgeon wore a digital dosimeter during an 12-month period whenever he performed a minimally invasive spine fusion. The patient demographic information, the procedure, number of screws, radiation exposure during various parts of the procedure (set-up, anterior approach, screw placement, etc.) were recorded in a radiation database. The physician practiced the principals of ALARA, including pulse and low dose imaging and stepping away, whenever the procedure allowed.

Results: During a 12 month period, 55 minimally invasive spine fusions were performed. In total, 330 percutaneous pedicle screws were placed, with an average radiation dose to the patient of 0.46 Rad/screw. The average total radiation exposure to the surgeon was 1.06 +/- 0.71 µSv/screw. When comparing patient and physician exposure, the correlation coefficient (r) for these two variables was calculated to be 0.77, indicating a positive correlation. The coefficient of determination (r2) was determined from the trend line to be 0.5928. Thus, 59.3% of the variability in radiation exposure to the surgeon is explained by radiation exposure to the patient. The average dose was decreased when using the low dose/pulse setting compared to the general setting for both the surgeon (p = 0.0002) and the patient (p < 0.001).