Surgeon and staff radiation exposure in minimally invasive spinal surgery: prospective series using a personal dosimeter
Surgeon and staff radiation exposure in minimally invasive spinal surgery: prospective series using a personal dosimeter
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DOI：
10.3171/2019.11.spine19448
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发表时间：
2020-06-01
影响因子：
2.8
通讯作者：
Tumialan, Luis M.
中科院分区：
文献类型：
--
作者：
Godzik, Jakub;Mastorakos, George M.;Tumialan, Luis M.
OBJECTIVE The level of radiation awareness by surgeons and residents in spinal surgery does not match the ubiquity of fluoroscopy in operating rooms in the United States. The present method of monitoring radiation exposure may contribute to the current deficiency in radiation awareness. Current dosimeters involve a considerable lag from the time that the surgical team is exposed to radiation to the time that they are provided with that exposure data. The objective of the current study was to assess the feasibility of monitoring radiation exposure in operating room personnel during lateral transpsoas lumbar interbody fusion (LLIF) and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) procedures by using a wearable personal device with real-time feedback.METHODS Operating room staff participating in minimally invasive surgical procedures under a single surgeon during a 6-month period were prospectively enrolled in this study. All radiation dose exposures were recorded for each member of the surgical team (surgeon, assistant surgeon, scrub nurse, and circulating nurse) using a personal dosimeter (DoseAware). Radiation doses were recorded in microsieverts (mu Sv). Comparisons between groups were made using ANOVA with the Tukey post hoc test and Student t-test.RESULTS Thirty-nine patients underwent interbody fusions: 25 underwent LLIF procedures (14 LLIF alone, 11 LLIF with percutaneous screw placement [PSP]) and 14 underwent MI-TLIF. For each operative scenario per spinal level, the surgeon experienced significantly higher (p < 0.035) average radiation exposure (LLIF: 167.9 mu Sv, LLIF+PSP: 424.2 mu Sv, MI-TLIF: 397.9 mu Sv) than other members of the team, followed by the assistant surgeon (LLIF: 149.7 mu Sv, LLIF+PSP: 242.3 mu Sv, MI-TLIF: 274.9 mu Sv). The scrub nurse (LLIF: 15.4 mu Sv, LLIF+PSP: 125.7 mu Sv, MI-TLIF: 183.0 mu Sv) and circulating nurse (LLIF: 1.2 mu Sv, LLIF+PSP: 9.2 mu Sv, MI-TLIF: 102.3 mu Sv) experienced significantly lower exposures. Radiation exposure was not correlated with the patient's body mass index (p >= 0.233); however, it was positively correlated with increasing patient age (p
