[Assessment of patient and neurosurgeon radiation exposure using a direct-reading dosimeter during transpedicular fixation for thoracic and lumbar spine injuries].

Abstract

Introduction: Individual dosimetry is routinely performed using thermoluminescent dosimeters (TLDs). Total dose is accumulated in these devices and periodically recorded by an accredited laboratory. This method does not provide real-time information on intraoperative radiation exposure.

Objective: To compare X-ray doses received by patients with traumatic thoracic and/or lumbar spine injury during open and minimally invasive interventions.

Material and methods: Ninety-two patients underwent surgery for thoracic and/or lumbar spine injury. Intraoperative analysis included dose-area products (DAP, cGy×cm²), individual TLD dosimeter readings of surgeons. Individual radiation dose equivalent was determined using four direct-reading dosimeters positioned on the operating table at distances of 0, 40, 80, and 120 cm from direct beam of radiation source.

Results: Fifty-four patients underwent open surgery, 38 - transcutaneous procedure. Mean DAP was 2171 cGy×cm², mean radiation dose equivalent - 1.6 mSv. Minimally invasive procedures were associated with significantly higher radiation exposure: median DAP 3408.8 cGy×cm² and dose equivalent 2.3 mSv compared to 327.8 cGy×cm² and 0.2 mSv for open surgeries. Neurosurgeon radiation exposure did not exceed standards.

Conclusion: Patient radiation exposure is significantly higher during minimally invasive procedures compared to open surgeries (mean dose equivalent 3 mSv versus 0.6 mSv). Understanding the patterns of radiation field is necessary for informed and safe use of X-rays.