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Comparison of Radiation Exposure in Lumbar Pedicle Screw Placement With Fluoroscopy Vs Computer-Assisted Image Guidance With Intraoperative Three-Dimensional Imaging
| Content Provider | Scilit |
|---|---|
| Author | Smith, Harvey E. Welsch, Matthew D. Ugurlu, Hatice Sasso, Rick C. Vaccaro, Alexander R. |
| Copyright Year | 2008 |
| Abstract | Background/objective: Little is known about the long-term effects of chronic exposure to ionizingradiation. Studies have shown that spine surgeons may be exposed to significantly more radiation than thatobserved in surgery on the appendicular skeleton. Computer-assisted image guidance systems have beenshown in preliminary studies to enable accurate instrumentation of the spine. Computer-assisted image guidance systems may havesignificant application to the surgical management of spinal trauma and deformity. The objective of this study was to compare C-arm fluoroscopy and computer-assisted imageguidance in terms of radiation exposure to the operative surgeon when placing pedicle screw-rod constructsin cadaver specimens. Methods: Twelve single-level (2 contiguous vertebral bodies) lumbar pedicle screw-rod constructs (48screws) in 4 fresh cadavers were placed using standard C-arm fluoroscopy and computer-assisted imageguidance (Stealth Station with $lso-C^{3D}$ ).Pedicle screw-rod constructs were placed at L1-L2, L3-L4, and L5-S1 in 4 fresh cadaver specimens. Imaging was alternated between C-arm fluoroscopy and computer-assistedimage guidance with Stealth Station $lso-C^{3D}$. Radiation exposure was measured using ringand badge dosimeters to monitor the thyroid, torso, and index finger. Postprocedure CT scans were obtained to judge accuracy of screw placement. Results: Mean radiation exposure to the torso was 4.33 ± 2.66 mRemfor procedures performed with standard fluoroscopy and 0.33 ± 0.82 mRem for procedures performed with computer-assisted image guidance. This difference was statistically significant (P = 0.012). Radiation exposure to the index finger and thyroid was negligible for all procedures. The accuracy of screw placement was similar for both techniques. Conclusions: Computer-assisted image guidance systems allow for the safe and accurate placement ofpedicle screw-rod constructs with a significant reduction in exposure to ionizing radiation to the torso of theoperating surgeon. |
| Related Links | http://europepmc.org/articles/pmc2607125?pdf=render |
| Ending Page | 537 |
| Page Count | 6 |
| Starting Page | 532 |
| ISSN | 10790268 |
| e-ISSN | 20457723 |
| DOI | 10.1080/10790268.2008.11753648 |
| Journal | The Journal of Spinal Cord Medicine |
| Issue Number | 5 |
| Volume Number | 31 |
| Language | English |
| Publisher | Informa UK Limited |
| Publisher Date | 2008-01-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: The Journal of Spinal Cord Medicine Orthopedics C-arm Fluoroscopy Radiation Exposure Minimally Invasive Surgery, Computer-assisted, Imageguided Pedicle Screw Intraoperative Imaging Surgical Navigation Systems |
| Content Type | Text |
| Resource Type | Article |
| Subject | Neurology (clinical) |
