Radiation doses to patients during pedicle screw fixation of the spine-Reference-Cited by-同舟云学术

Radiation doses to patients during pedicle screw fixation of the spine

Published:2023-12-19 Issue:4 Volume:20 Page:84-91
ISSN:2313-1497
Container-title:Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika)
language:
Short-container-title:Hir. pozvonoč.

Author:

Kubasov M. V.¹^ORCID,Kravtsov M. N.²^ORCID,Golubin A. V.³^ORCID,Malakhovsky V. N.⁴^ORCID,Svistov D. V.⁵^ORCID

Affiliation:

1. North-Western State Medical University n.a. I.I. Mechnikov 41 Kirochnaya str., St. Petersburg, 191015, Russia

2. S.M. Kirov Military Medical Academy; Research Institute of Emergency Medicine n.a. I.I. Dzhanelidze; North-Western State Medical University n.a. I.I. Mechnikov 6 Academika Lebedeva str., St. Petersburg, 194044, Russia; 3 Budapeshtskaya str., St. Petersburg, 192242, Russia; 41 Kirochnaya str., St. Petersburg, 191015, Russia

3. S.M. Kirov Military Medical Academy 6 Academika Lebedeva str., St. Petersburg, 194044, Russia

4. S.M. Kirov Military Medical Academy 6 Academika Lebedeva str., St. Petersburg, 194044, Russia

5. S.M. Kirov Military Medical Academy 6 Akademika Lebedeva str., St. Petersburg, 194044, Russia

Abstract

Objective. To analyze the radiation doses to patients during spinal decompression and stabilization surgery under optical CT navigation and fluoroscopy.Material and Methods. Study design: retrospective cohort study. The sample consisted of 164 patients who underwent transpedicular fixation of the spine performed by percutaneous or open techniques. In the O-arm group (n = 109), cone-beam CT combined with optical navigation was used; in the C-arm group, fluoroscopy (n = 55) was used. The effective dose equivalent (EDE) and the maximum absorbed dose (MAD) in the skin were evaluated.Results. EDE in the O-arm group was Me 9.1 mSv, [IQR: 7.1–11.6], and in the C-arm group –Me 1.8 mSv [IQR: 1.8–5.6], p < 0.0001. Maximum absorbed dose in the skin in the O-arm group was Me 49.3 mGy [IQR: 27.0–96.9], and in the C-arm group – Me 36.1 mGy [IQR: 16.6–111.5], p = 0.424.Conclusion. The use of CT navigation and fluoroscopy during pedicle screw fixation of the spine is not associated with the risk of developing deterministic effects. The use of intraoperative CT navigation during pedicle screw fixation is associated with a greater patient EDE compared with that of fluoroscopy (p < 0.05). Differences in EDE received by patients undergoing open and percutaneous techniques of pedicle screw fixation are statistically insignificant, regardless of the type of beam guidance and the number of fixation levels. The number of intraoperative CT scans is proportional to the patient EDE (p = 0.018).

Publisher

Association of Spine Surgeons

Subject

Anesthesiology and Pain Medicine,Orthopedics and Sports Medicine,Surgery

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