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Surgeon radiation exposure in cone beam computed tomography‐based, image‐guided spinal surgery
Author(s) -
Nottmeier Eric W.,
Bowman Cammi,
Nelson Kevin L.
Publication year - 2012
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.450
Subject(s) - medicine , cone beam computed tomography , radiation exposure , dosimeter , spinal surgery , nuclear medicine , image guided surgery , medical physics , radiology , computed tomography , surgery , dosimetry
Background 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. Copyright © 2011 John Wiley & Sons, Ltd.