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Radiation exposure to the patients in thoracic and lumbar spine fusion using a new intraoperative cone-beam computed tomography imaging technique: a preliminary study.

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Kaminski, Ludovic [UCL] Cordemans, Virginie [UCL] Cartiaux, Olivier [UCL] Van Cauter, Maïté [UCL]

(eng) PURPOSE: The goals of this paper are to assess the ionizing radiation exposure to the patients during thoracic and lumbar spinal fusion using a new intraoperative 3D imaging system and to evaluate the factors that could explain the variability in the observed doses. METHOD: We retrospectively reviewed 97 patients who underwent posterior instrumented thoracic and/or lumbar spinal fusion from December 2013 to November 2014. Primary data were the total dose area product (total DAP, Gy cm2) and total skin dose (total SD, mGy). Influence of different variables (patient characteristics, surgical technique, and intraoperative imaging system parameters) that could influence patients' exposure was analyzed. RESULTS: Radiation dose imparted to patients depended on four parameters including acquisition protocol, surgical technique, patient's BMI and operative time. Minimally invasive surgery (MIS) resulted in twofold higher dose for patients, compared to open surgery. The use of low dose acquisition protocols reduced patient exposure by a factor three. CONCLUSION: Patient exposure was highly variable. Four parameters were found to explain about 68% of its variance when using a multi-axis robotic C-arm system. MIS technique (with navigation or not) as well as the acquisition protocol dramatically increases the radiation dose for patients. These results show the necessity to develop specific strategies adapted to patients and surgical procedures.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2017
Language Anglais
Journal information "European Spine Journal" - Vol. 26, no. 11, p. 2811-2817 (2017)
Peer reviewed yes
Publisher Springer-Verlag ((Germany) Heidelberg)
issn 0940-6719
e-issn 1432-0932
Publication status Publié
Affiliations UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur
UCL - SSS/IREC/CARS - Computer Assisted Robotic Surgery
UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab
Keywords Cone-beam CT ; Dose reduction strategies ; Intraoperative imaging ; Minimally invasive surgery ; Mobile C-arm ; Pedicle screws ; Radiation exposure
Links
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Bibliographic reference Kaminski, Ludovic ; Cordemans, Virginie ; Cartiaux, Olivier ; Van Cauter, Maïté. Radiation exposure to the patients in thoracic and lumbar spine fusion using a new intraoperative cone-beam computed tomography imaging technique: a preliminary study.. In: European Spine Journal, Vol. 26, no. 11, p. 2811-2817 (2017)
Permanent URL http://hdl.handle.net/2078.1/183039