脊柱手术中基于 O 型臂三维导航的术中辐射暴露。

IF 1.2 Q3 SURGERY
Spine Surgery and Related Research Pub Date : 2023-07-06 eCollection Date: 2023-11-27 DOI:10.22603/ssrr.2023-0057
Kazuya Yokota, Osamu Kawano, Hiroaki Sakai, Yuichiro Morishita, Muneaki Masuda, Tetsuo Hayashi, Kensuke Kubota, Hideaki Hirashima, Ryota Nakashima, Yasuharu Nakashima, Takeshi Maeda
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引用次数: 0

摘要

导言:术中三维(3D)成像引导技术,如 O 型臂手术成像系统,是脊柱手术中的一种有益工具,可提供患者脊柱的实时三维图像。本研究旨在确定术中 O 型臂成像的暴露剂量:方法:在 2019 年 6 月至 2022 年 8 月期间,对所有接受脊柱手术的患者进行了连续回顾性研究。从电子病历中收集人口统计学和手术数据:1599例患者中有206例(12.9%)进行了术中O型臂成像,每位患者扫描1至4次不等(1.17±0.43次)。单次 O 型臂成像平均可导航颈椎 7 个椎体、胸椎 7 个椎体、胸腰椎 5 个椎体和腰椎 4 个椎体。颈椎、胸椎、胸腰椎和腰椎病例每次手术的 O 型臂注射次数分别为 1.15±0.36、1.06±0.24、1.61±0.7 和 1.07±0.25。颈椎、胸椎、胸腰椎和腰椎的单次O型臂成像剂量长度乘积分别为377±19 mGy-cm、243±22 mGy-cm、378±38 mGy-cm和258±11 mGy-cm。我们观察到脊柱融合层数与照射剂量之间存在微弱的正相关性:结论:O 型臂成像的术中辐射量低于根据国际放射防护委员会出版物制定的日本国家诊断参考水平,从放射防护的角度来看,在大多数情况下都是安全的。在畸形矫正手术等固定范围较大的手术中,成像次数和术中辐射量都会增加,因此外科医生应注意脊柱手术中的辐射风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Intraoperative Radiation Exposure from O-arm-based 3D Navigation in Spine Surgery.

Introduction: Intraoperative three-dimensional (3D) imaging guide technology, such as the O-arm surgical imaging system, is a beneficial tool in spinal surgery that provides real-time 3D images of a patient's spine. This study aims to determine the exposure dose from intraoperative O-arm imaging.

Methods: A consecutive retrospective review of all patients undergoing spinal surgery was conducted between June 2019 and August 2022. Demographic and operative data were collected from electronic medical records.

Results: Intraoperative O-arm imaging was conducted in 206 (12.9%) of 1599 patients, ranging from one to 4 scans per patient (1.17±0.43 scans). Single O-arm imaging enabled navigation of seven vertebrae in the cervical spine, seven in the thoracic spine, five in the thoracolumbar spine, and four in the lumbar spine on average. The number of O-arm shots per surgery was 1.15±0.36, 1.06±0.24, 1.61±0.7, and 1.07±0.25 for cervical, thoracic, thoracolumbar, and lumbar spinal cases, respectively. The exposure doses represented by dose length products in single O-arm imaging were 377±19 mGy-cm, 243±22 mGy-cm, 378±38 mGy-cm, and 258±11 mGy-cm for cervical, thoracic, thoracolumbar, and lumbar spine cases, respectively. We observed a weak positive correlation between the number of fused spinal levels and the exposure dose.

Conclusions: Intraoperative radiation exposure from O-arm imaging was lower than the national diagnostic reference levels in Japan established based on the International Commission on Radiological Protection publication, demonstrating its safety from the standpoint of radiological protection in most cases. In surgeries with a large range of fixations, such as corrective deformity surgery, the number of imaging sessions and the amount of intraoperative radiation exposure would increase, leading surgeons to pay attention to the risk of radiation in spinal surgery.

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CiteScore
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