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Klingler, J.H.* ; Scholz, C.* ; Krüger, M.T.* ; Naseri, Y.* ; Volz, F.* ; Hohenhaus, M.* ; Brönner, J. ; Hödlmoser, H. ; Sircar, R.* ; Hubbe, U.*

Radiation exposure in minimally invasive lumbar fusion surgery: A randomized controlled trial comparing conventional fluoroscopy and 3D fluoroscopy-based navigation.

Spine 46, 1-8 (2021)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
STUDY DESIGN: Randomized controlled trial. OBJECTIVE: The aim of this study was to compare the dosemetrically determined radiation exposure of surgeon and patient during minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) using conventional 2D fluoroscopy (FLUORO) or 3D fluoroscopy-based navigation (NAV). SUMMARY OF BACKGROUND DATA: MIS TLIF was shown to exhibit higher radiation exposures compared to open techniques. In particular, the routinely exposed surgeon encounters the risks of increased radiation doses. With the additional use of intraoperative 3D navigation, major steps of the operation can be performed without exposing the operating room staff to ionizing radiation. METHODS: Forty-four patients undergoing monosegmental MIS TLIF were randomized into the two intraoperative imaging technique groups (FLUORO or NAV). The primary endpoint was the radiation exposure of the surgeon; the secondary endpoints were the radiation exposure of the patient and C-arm readings. RESULTS: After exclusion of three patients, 41 patients were analyzed. In general, the average radiation exposure of the surgeon was lower in the NAV group without being statistically significant. The radiation exposure of the patient was significantly higher in the NAV group at all dosemeter sites. The average fluoroscopy time was 63 ± 36 versus 109 ± 31 sec (FLUORO versus NAV group, P < 0.001). CONCLUSION: The additional use of intraoperative 3D fluoroscopy-based navigation compared to conventional 2D fluoroscopy alone showed a nonsignificant reduction of the radiation exposure of the surgeon in monosegmental MIS TLIF, while increasing the radiation exposure of the patient.1.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Digital Volume Tomography ; Dosimetry ; Fluoroscopy ; Minimally Invasive ; Navigation ; Radiation Exposure ; Spine Surgery; Pedicle Screw Insertion; Interbody Fusion; Patient
ISSN (print) / ISBN 0362-2436
e-ISSN 1528-1159
Journal Spine
Quellenangaben Volume: 46, Issue: 1, Pages: 1-8 Article Number: , Supplement: ,
Publisher Lippincott Williams & Wilkins
Publishing Place Two Commerce Sq, 2001 Market St, Philadelphia, Pa 19103 Usa
Reviewing status Peer reviewed
Institute(s) Auswertungsstelle (AWST)
Grants Scientific Society Freiburg (Germany)