Int J Med Robot - Surgeon radiation exposure in cone beam computed tomography-based, image-guided spinal surgery.

Tópicos

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Resumo

CKGROUND: Radiation exposure to the surgeon is a concern in spinal surgery, especially with the increasing popularity of minimally invasive spinal surgery techniques. Three-dimensional (3D) image guidance used in conjunction with cone beam computed tomography (cbCT) has a theoretical advantage of decreased radiation exposure to the surgeon and operating room (OR) staff. Radiation scatter to the environment immediately surrounding a CT scanner during acquisition of a CT scan is a known entity. This in vivo study measures the radiation exposure to the surgeon when using cbCT registration in 3D image-guided spinal surgery.METHODS: Two badge dosimeters were worn by the surgeon (EWN), one on the right waistband of the surgeon's scrubs and the other located over the thyroid area during 25 consecutive spinal surgery cases in which cbCT was used in conjunction with 3D image guidance. No lead protection was worn by the surgeon. The cbCT device was used for registration of the anatomy and to confirm adequate instrumentation placement. The surgeon stood behind a clear lead shield in the same location during every spin of the cbCT device. After the 25th case, the badge dosimeters were sent to the radiology department for analysis.RESULTS: Overall, 63 cbCT spins were accomplished in 25 patients. A total of 228 screws were placed into spinal levels spanning from C2 to the ileum. No complications resulted from instrumentation placement or the use of image guidance.Analysis of both badge dosimeters revealed 0 millirem (mRem) exposure.CONCLUSIONS: Our study demonstrates that no radiation exposure to the surgeon occurs in cbCT-based, 3D image-guided spinal surgery procedures. Additionally, radiation scatter does not result in surgeon radiation exposure during patient registration if the surgeon stands behind a lead shield 10 feet from the cbCT device and not in direct line with the opening of the cbCT tube.

Resumo Limpo

ckground radiat exposur surgeon concern spinal surgeri especi increas popular minim invas spinal surgeri techniqu threedimension d imag guidanc use conjunct cone beam comput tomographi cbct theoret advantag decreas radiat exposur surgeon oper room staff radiat scatter environ immedi surround ct scanner acquisit ct scan known entiti vivo studi measur radiat exposur surgeon use cbct registr d imageguid spinal surgerymethod two badg dosimet worn surgeon ewn one right waistband surgeon scrub locat thyroid area consecut spinal surgeri case cbct use conjunct d imag guidanc lead protect worn surgeon cbct devic use registr anatomi confirm adequ instrument placement surgeon stood behind clear lead shield locat everi spin cbct devic th case badg dosimet sent radiolog depart analysisresult overal cbct spin accomplish patient total screw place spinal level span c ileum complic result instrument placement use imag guidanceanalysi badg dosimet reveal millirem mrem exposureconclus studi demonstr radiat exposur surgeon occur cbctbase d imageguid spinal surgeri procedur addit radiat scatter result surgeon radiat exposur patient registr surgeon stand behind lead shield feet cbct devic direct line open cbct tube

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