A Cadaveric Simulation Study of Radiation Exposure to the Surgical Team during Fluoroscopic Spinal Surgery: How Much Are We Exposed?

Abstract

Introduction: The harmful effects of long-term low-dose radiation have been well known. There are few comprehensive reports evaluating concrete real exposure doses for each part of a surgeon, assistant surgeon, scrub nurse, and anesthesiologist associated with fluoroscopic spinal procedures. This research aimed to quantify the radiation exposure dose to surgical team members during C-arm fluoroscopy-guided spinal surgery. Methods: Seven fresh cadavers were irradiated for 1 and 3 min with C-arm fluoroscopy. The position of the X-ray source was under the table, over the table, and laterally. The radiation exposure doses were measured at the optic lens, thyroid gland, and hand in mannequins used to simulate surgical team members. Results: A significant difference was observed in the radiation exposure dose according to the position of the X-ray source and the irradiated body area. The risk of scatter radiation exposure was the biggest for the lateral position (nearly 30-fold that for the position under the table). All radiation exposure doses were positively correlated with irradiation time. Conclusions: The occupational radiation exposure dose to surgical team members during C-arm fluoroscopy-guided lumbar spinal procedures varies according to the X-ray source position. Our findings would help surgical team members to know the risk of radiation exposure during various fluoroscopic procedures. Surgeons in particular need to reduce their radiation exposure by using appropriate shielding and technique.

Keywords

• radiation exposure
• fluoroscopy
• cadaver study
• minimally invasive surgery
• scatter radiation
• occupational radiation exposure