Spine Surgery and Related Research最新文献

{"title":"Anterior Placement of Cages in Posterior Lumbar Interbody Fusion for Obtaining Good Lumbar Lordosis Formation.","authors":"Daisuke Inoue, Hideki Shigematsu, Hiroaki Matsumori, Yurito Ueda, Toshiya Morita, Sachiko Kawasaki, Yuma Suga, Masaki Ikejiri, Yasuhito Tanaka","doi":"10.22603/ssrr.2023-0133","DOIUrl":"10.22603/ssrr.2023-0133","url":null,"abstract":"<p><strong>Introduction: </strong>Posterior lumbar interbody fusion (PLIF) is a common treatment for nerve root disease associated with lumbar foraminal stenosis or lumbar spondylolisthesis. At our institution, PLIF is usually performed with high-angle cages and posterior column osteotomy (PLIF with HAP). However, not all patients achieve sufficient segmental lumbar lordosis (SLL). This study determined whether the location of PLIF cages affect local lumbar lordosis formation.</p><p><strong>Methods: </strong>A total of 59 patients who underwent L4/5 PLIF with HAP at our hospital, using the same titanium control cage model, were enrolled in this cohort study. The mean ratio of the distance from the posterior edge of the cage to the posterior wall of the vertebral body/vertebral length (RDCV) immediately after surgery was 16.5%. The patients were divided into two groups according to RDCV <16.5% (group P) and ≥16.5% (group G). The preoperative and 6-month postoperative slip rate (%slip), SLL, local disk angle (LDA), ratio of disk height/vertebral height (RDV), 6-month postoperative RDCV, ratio of cage length/vertebral length (RCVL), and ratio of posterior disk height/anterior disk height at the fixed level (RPA) were evaluated via simple lumbar spine X-ray. The preoperative and 6-month postoperative Japanese Orthopedic Association (JOA) and low back pain visual analog scale (VAS) scores were also evaluated.</p><p><strong>Results: </strong>Groups G and P included 31 and 28 patients, respectively. The preoperative %slip, SLL, LDA, RDV, JOA score, and low back pain VAS score were not significantly different between the groups. In groups G and P, 6-month postoperative %slip, SLL, LDA, RDV, RDCV, RCVL, and RPA were 3.3% and 7.9%, 18.6° and 15.4°, 9.7° and 8.0°, 36.6% and 40.3%, 21.1% and 10.1%, 71.4% and 77.0%, and 56.1% and 67.7%, respectively. The 6-month postoperative SLL, LDA, RDV, RDCV, RCVL, and RPA significantly differed (<i>p</i>=0.03, 0.02, 0.02, <0.001, <0.001, and <0.001, respectively).</p><p><strong>Conclusions: </strong>Anterior PLIF cage placement relative to the vertebral body is necessary for good SLL in PLIF.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"1 1","pages":"51-57"},"PeriodicalIF":1.2,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10853625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68231049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sacral Nerve-Sparing Piecemeal Spondylectomy for Giant Cell Tumor of Bone in the Sacrum: Surgical Strategy and Accurate Tumor Location Identification.","authors":"Bungo Otsuki, Akio Sakamoto, Shunsuke Fujibayashi, Takayoshi Shimizu, Koichi Murata, Takashi Noguchi, Shuichi Matsuda","doi":"10.22603/ssrr.2023-0145","DOIUrl":"10.22603/ssrr.2023-0145","url":null,"abstract":"","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"1 1","pages":"110-113"},"PeriodicalIF":1.2,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10853623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68231123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of Conventional Two-Dimensional Magnetic Resonance Imaging for Diagnosing Extraforaminal Stenosis in Lumbosacral Transition.","authors":"Kohei Takahashi, Myo Min Latt, Takumi Tsubakino, Manabu Suzuki, Takeshi Nakamura, Takeshi Hoshikawa, Tomowaki Nakagawa, Ko Hashimoto, Takahiro Onoki, Toshimi Aizawa, Yasuhisa Tanaka","doi":"10.22603/ssrr.2023-0110","DOIUrl":"10.22603/ssrr.2023-0110","url":null,"abstract":"<p><strong>Introduction: </strong>Three-dimensional (3D) magnetic resonance imaging (MRI) is reportedly superior to two-dimensional (2D) MRI for diagnosing lumbar foraminal stenosis at L5-S1. In this study, we strictly distinguished the intra- and extraforaminal regions and compared the diagnostic reliability and accuracy of 2D and 3D MRI in each region.</p><p><strong>Methods: </strong>A total of 92 surgical cases of unilateral L5 radiculopathy were selected for imaging analysis, including 46 of foraminal stenosis at L5-S1 (Group F) and 46 of intraspinal canal stenosis at L4-5 (Group C) (48 men, 44 women; mean age, 66 years). The 2D and 3D MRI sets were assessed twice by two examiners. They were informed only of the laterality of the lesion in each case and asked to select among the following for each modality: \"absence of foraminal stenosis,\" \"intraforaminal stenosis,\" \"extraforaminal stenosis,\" and \"coincident intraforaminal and extraforaminal stenosis.\" The intra- and interobserver reliabilities were evaluated using kappa (κ) statistics for the intra- and extraforaminal regions and compared between 2D and 3D MRI. For each case, disagreements between examiners were resolved through discussion to obtain a diagnostic judgment for each modality. Subsequently, the final diagnosis of intra- and/or extraforaminal stenosis in Group F was made using multiple modalities and intraoperative findings. A comparison between 2D and 3D MRI in terms of diagnostic accuracy was performed for the intra- and extraforaminal regions.</p><p><strong>Results: </strong>No significant difference was observed in the κ statistics between 2D and 3D MRI for the intraforaminal region, whereas 3D MRI had significantly larger κ statistic than 2D MRI for the extraforaminal region. Ultimately, 3D MRI perfectly judged the extraforaminal region, whereas 2D MRI detected only 44.8% of the cases of extraforaminal stenosis.</p><p><strong>Conclusions: </strong>More than half of extraforaminal stenosis was overlooked by 2D MRI, suggesting that it is unreliable for diagnosing extraforaminal stenosis at L5-S1.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"1 1","pages":"526-532"},"PeriodicalIF":1.2,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10710884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68230380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Options for Failed Back Surgery Syndrome: An Umbrella Systematic Review of Systematic Reviews on the Effectiveness of Therapeutic Interventions.","authors":"Hernán Gallego, Sergio Arango, Andrés Combalia, Salvador Fuster, Catalina Jaramillo, Ana Milena Herrera","doi":"10.22603/ssrr.2023-0032","DOIUrl":"10.22603/ssrr.2023-0032","url":null,"abstract":"<p><strong>Background: </strong>Failed back surgery syndrome (FBSS) is a common and incapacitating condition affecting patients with previous spine surgery in whom treatment approach can be challenging. This study aimed to summarize existing secondary studies and up-to-date randomized clinical trials (RCTs) that assess the effectiveness of available treatment options for FBSS.</p><p><strong>Methods: </strong>Systematic searches were carried out in five databases (PubMed, Cochrane, Scielo, Epistemonikos, and Google scholar) for all systematic reviews on the effectiveness of treatment options for FBSS published after 2012. Outcomes of interest were pain levels measured through visual analog scale or numeric rating scale, Oswestry Disability Index, and quality of life. Methodological and risk of bias assessments were performed with the AMSTAR-2 tool for systematic reviews and the Joanna Briggs Institute checklist for RCT. Prospective PROSPERO registration: CRD42022307609.</p><p><strong>Results: </strong>Fifteen studies, seven systematic reviews, and eight RCTs met the inclusion criteria and fulfilled the methodological quality assessment. Of the 15 included studies, 8 were on neurostimulation, 4 on adhesiolysis, 4 on epidural or intrathecal injections, and 3 on other treatment modalities. The risk of bias was low in seven studies, moderate in five, and high in three.</p><p><strong>Conclusions: </strong>Based on this systematic overview and the considerable heterogeneity among studies, the FBSS therapeutic approach must be individualized. FBSS treatment should start with conservative management, considering the implementation of neurostimulation, a technique with the most robust evidence of effective results, in cases of refractory axial or neuropathic pain. As the last resource, in light of the evidence found, more invasive procedures or new surgical interventions are indicated.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"1 1","pages":"143-154"},"PeriodicalIF":1.2,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11007241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68230504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesenchymal Stem Cell Transplantation for Spinal Cord Injury: Current Status and Prospects.","authors":"Ryosuke Hirota,&nbsp;Masanori Sasaki,&nbsp;Osamu Honmou,&nbsp;Toshihiko Yamashita","doi":"10.22603/ssrr.2022-0234","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0234","url":null,"abstract":"<p><p>Since the 1990s, our group has been conducting basic research on regenerative medicine using various cell types to treat several central nervous system diseases, including spinal cord injury (SCI). We have reported many positive effects of the intravenous administration of mesenchymal stem cells (MSCs) derived from the bone marrow. In the current study, MSCs were administered intravenously to a rat model of severe SCI (crush injury) during the acute to subacute stages-considerable motor function recovery was observed. Furthermore, MSC transplantation in a chronic-phase SCI model improved motor function. In this review, we discuss recent updates in basic research on the intravenous infusion of MSCs and prospects for SCI research.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"7 4","pages":"319-326"},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/36/63/2432-261X-7-0319.PMC10447197.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10108270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary Osteoporosis with Normal Bone Mineral Density: A Case of Compression Fracture and Spinal Cord Injury in Cushing's Disease.","authors":"Mohamed Sarraj,&nbsp;Ahmed Saidahmed,&nbsp;Patrick Thornley,&nbsp;Frank Koziarz,&nbsp;Rami Abou Khamis,&nbsp;Thorsten Jentzsch,&nbsp;Kunal Bhanot,&nbsp;Colby Oitment","doi":"10.22603/ssrr.2022-0187","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0187","url":null,"abstract":"1) McMaster University, Division of Orthopedic Surgery, Department of Surgery, Hamilton General Hospital, Ontario, Canada 2) McMaster University, Department of Internal Medicine, Hamilton General Hospital, Ontario, Canada 3) Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland 4) Division of Orthopaedic Surgery, St. Michael’s Hospital, Ontario, Canada 5) Division of Orthopedic Surgery, Western University, Ontario, Canada 6) McMaster University, Department of Health Research Methods, Evidence and Impact, Ontario, Canada","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"7 4","pages":"406-409"},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8a/42/2432-261X-7-0406.PMC10447193.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10163403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographical Results of Adolescent Idiopathic Scoliosis with Major Curve at Proximal Thoracic Spine.","authors":"Yosuke Horiuchi,&nbsp;Mitsuru Yagi,&nbsp;Satoshi Suzuki,&nbsp;Yohei Takahashi,&nbsp;Satoshi Nori,&nbsp;Osahiko Tsuji,&nbsp;Narihito Nagoshi,&nbsp;Morio Matsumoto,&nbsp;Masaya Nakamura,&nbsp;Kota Watanabe","doi":"10.22603/ssrr.2022-0088","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0088","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescent idiopathic scoliosis (AIS) with a major curve at the main thoracic (MT) area is classified as Lenke type 1, 2, or 3 depending on the flexibility of the proximal thoracic (PT) curve and lumbar curve. No definite classification has been established for a major curve at the PT spine. The purpose of this study is to investigate the radiographic characteristics before and after correction surgery for AIS with a major curve at the PT area.</p><p><strong>Methods: </strong>This is a retrospective cohort study at a single academic institution. Twelve patients with a major curve at the PT spine participated in our study and followed for at least two years after surgery. We evaluated the pre- and postoperative Cobb angles of the curve, curve range, location of the apex, sagittal parameters, and shoulder balance-related parameters. All patients were treated by posterior correction and fusion surgery using pedicle screw constructs.</p><p><strong>Results: </strong>The patients were classified as having a double-curve (DC) type, in which the MT curve was structural, or a single-curve (SC) type, in which the MT curve was corrected to less than 25° on supine side-bending films. The mean correction rates for the PT curve were favorable in both groups (DC, 65.7%±9.6%; SC, 39.2%±4.9%). The mean Cobb angle of the lumbar curve improved in the DC group (preoperative, 17.1°±4.0°; postoperative, 5.0°±4.2°) but deteriorated in the SC group (preoperative, 7.1°±1.2°; postoperative, 12.4°±4.4°) after surgery.</p><p><strong>Conclusions: </strong>We illustrated the postoperative radiographical changes of 12 consecutive patients with the major curve at the PT curve. Although posterior correction and fusion surgery corrected the PT curve satisfactorily in both DC and SC patients, the Cobb angle of the lumbar curve deteriorated after surgery in all SC patients. Surgeons need to pay attention to the fusion area, especially LIV, when operating the SC curve type.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"7 4","pages":"371-376"},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/03/94/2432-261X-7-0371.PMC10447189.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10108265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Cage Subsidence in Minimally Invasive Lateral Corpectomy for Osteoporotic Vertebral Fractures.","authors":"Shuhei Iwata,&nbsp;Toshiaki Kotani,&nbsp;Tsuyoshi Sakuma,&nbsp;Yasushi Iijima,&nbsp;Shun Okuwaki,&nbsp;Shuhei Ohyama,&nbsp;Satoshi Maki,&nbsp;Yawara Eguchi,&nbsp;Sumihisa Orita,&nbsp;Kazuhide Inage,&nbsp;Yasuhiro Shiga,&nbsp;Masahiro Inoue,&nbsp;Tsutomu Akazawa,&nbsp;Shohei Minami,&nbsp;Seiji Ohtori","doi":"10.22603/ssrr.2022-0215","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0215","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to investigate risk factors for cage subsidence following minimally invasive lateral corpectomy for osteoporotic vertebral fractures.</p><p><strong>Methods: </strong>Eight males and 13 females (77.2±6.0 years old) with osteoporotic vertebral fractures who underwent single corpectomy using a wide-footprint expandable cage with at least a 1-year follow-up were retrospectively included. The endplate cage (EC) angle was defined as the angle between the vertebral body's endplate and the cage's base on the cranial and caudal sides. A sagittal computed tomography scan was performed immediately after surgery and at the final follow-up, with cage subsidence defined as subsidence of ≥2 mm on the cranial or caudal side. Risk factors were analyzed by dividing cases into groups with (<i>n</i>=6) and without (<i>n</i>=15) cage subsidence.</p><p><strong>Results: </strong>No significant differences were noted in age, bone mineral density, number of fixed vertebrae, sagittal parameters, preoperative and final kyphosis angle, amount of kyphosis angle correction, bone union, screw loosening, and number of other vertebral fractures preoperatively and 1-year postoperatively between the two groups. No difference was noted in cranial EC angle, but a significant difference was noted in caudal EC angle in the group with (10.7±4.1°) and without (4.7±4.2°) subsidence (<i>P</i>=0.008). Logistic regression analysis with the dependent variable as presence or absence of subsidence showed that caudal EC angle (>7.5°) was a significant factor (odds ratio: 20, 95% confidence interval: 1.655-241.7, <i>P</i>=0.018).</p><p><strong>Conclusions: </strong>In minimally invasive lateral corpectomy for osteoporotic vertebral fractures, a cage tilted more than 7.5° to the caudal vertebral endplate is a risk factor for cage subsidence. The cage should be placed as perpendicular to the endplate as possible, especially to the caudal vertebral body, to avoid cage subsidence.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"7 4","pages":"356-362"},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ac/10/2432-261X-7-0356.PMC10447195.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10109068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the Intrathecal Baclofen Dose Need to Be Changed after Spinal Fusion Surgery for Neuromuscular Scoliosis?","authors":"Kathryn M DeFoe,&nbsp;Jeremiah Atkinson,&nbsp;Jean Stansbury,&nbsp;Angela Sinner,&nbsp;Walter H Truong","doi":"10.22603/ssrr.2022-0230","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0230","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with cerebral palsy (CP) may receive intrathecal baclofen (ITB) to reduce muscle spasticity and dystonia. It can be challenging to identify the proper dose of ITB, and anecdotally these dosing needs may change after spinal fusion surgery. This study aimed to evaluate the need for changes in ITB dosing following a spinal fusion in pediatric neuromuscular scoliosis (NMS) patients and identify predisposing factors for those changes.</p><p><strong>Methods: </strong>This was a retrospective case-control study of NMS patients with an ITB pump who later received a spinal fusion surgery. Dosing changes and the indications for the changes were postoperatively noted. Demographics, preoperative factors, and surgical factors were evaluated for correlation with dosing changes.</p><p><strong>Results: </strong>A total of 49 patients were included in this study. Most had no change in ITB dose (71.4%), and others required a change that averaged about 10%. Male patients, those with larger pumps, and those that had a longer hospital stay were more likely to require a decrease in dose. Complications were similar between groups. Three catheters were revised during surgery: two continued on the same dose and one required an increase in dose after surgery.</p><p><strong>Conclusions: </strong>Spinal fusion after ITB pump placement is feasible and safe. Most patients did not require dosing changes after spine fusion; however, careful evaluation postoperatively remains prudent.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"7 4","pages":"385-389"},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/d6/2432-261X-7-0385.PMC10447190.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10163402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cadaveric Simulation Study of Radiation Exposure to the Surgical Team during Fluoroscopic Spinal Surgery: How Much Are We Exposed?","authors":"Kazuta Yamashita,&nbsp;Yasuaki Tamaki,&nbsp;Daiki Nakajima,&nbsp;Yasuyuki Omichi,&nbsp;Yoshinori Takahashi,&nbsp;Michihiro Takai,&nbsp;Tomohiro Goto,&nbsp;Hiroaki Hayashi,&nbsp;Kosaku Higashino,&nbsp;Yoshihiro Tsuruo,&nbsp;Koichi Sairyo","doi":"10.22603/ssrr.2022-0184","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0184","url":null,"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.","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"7 4","pages":"341-349"},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2d/59/2432-261X-7-0341.PMC10447199.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10163404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}