Abstract
Introduction
The purpose of this study is to quantify the radiation exposure of the operating room personnel in fluoroscopy-assisted pedicle screw insertion during instrumented spine surgery, and to determine the protective effect of using a lead apron and increasing the distance between the subject and the X-ray source.
Material and Methods
We conducted a qualitative and quantitative analysis of personal dosimetry among the different members of the operating room personnel during 35 instrumented spine surgeries, using a pseudo experimental model (input–output) to determine the effect of protective measures (lead apron and distance from the radiation source). Statistical analysis was performed using a Student t test and one-way ANOVA.
Results
The mean radiation rate per procedure was 43.97 mGy (range, 12.3–137 mGy; SD = 30.9 mGy), with a mean exposure duration of 3 minutes and 6 seconds (1′14″–8′57″; SD = 2′02″). The use of a lead apron decreased the dose equivalent by 72.64% (p = < 0.00001). A distance of 70 cm from the fluoroscopy beam was associated with a 50.14% (p = 0.0089) dose equivalent reduction, while at 1 meter a 60.56% (p = 0.0013) reduction was observed. Finally, a distance of 1.5 m showed a reduction of 50.61% (p = 0.023). No statistically significant associations between exposure reduction and distance from the radiation source were detected (difference: 0.0005, p = 0.714).
Conclusion
Our study confirms the effectiveness of the use of a lead apron and highlights the importance of its proper use for reducing radiation exposure during instrumented spine surgery. It also confirms the benefit of increasing the distance from the radiation source for reducing the equivalent dose received by the operating room personnel. However, we did not identify a proportional association between dose reduction and greater distance from the X-ray beam.