Can Radiation Exposure to the Surgeon be Reduced With Free-Hand Pedicle Screw Fixation Technique in Pediatric Spinal Deformity Correction?: A Prospective Multi-Center Study.

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Can Radiation Exposure to the Surgeon be Reduced With Free-Hand Pedicle Screw Fixation Technique in Pediatric Spinal Deformity Correction?: A Prospective Multi-Center Study.

Spine (Phila Pa 1976). 2013 Dec 20;

Authors: Erken HY, Burc H, Saka G, Akmaz I, Aydogan M

Abstract
Study Design. Prospective multi-center study of patients who underwent pediatric spinal deformity correction with posterior spinal fusion and instrumentation.Objective. To quantify radiation exposure to the surgeon during pedicle screw fixation using the free-hand technique in pediatric spinal deformity surgery.Summary of Background Data. Pedicle screw placement in thoracic and lumbar spine for spinal deformity is technically demanding and involves radiation exposure. Many experienced spinals surgeons use the free-hand technique for pedicle screw fixation in spinal deformity surgery. There are no studies analyzing radiation exposure to the surgeon regarding free-hand pedicle screw fixation technique.Methods. A prospective multicenter study was designed in order to evaluate radiation exposure to the operating spinal surgeon who uses the free-hand pedicle screw fixation technique in pediatric spinal deformity correction. All of the operating surgeons placed a gamma radiation dosimeter on their chest outside the lead apron during surgery. Surgeons placed pedicle screws in the pediatric spinal deformity using the free-hand technique. We included patients who had undergone correction with posterior spinal fusion and instrumentation (PSFI) with all pedicle screw constructs in this study.Results. We analyzed 125 patients with pediatric spinal deformity who were operated on between 2008 and 2012. The average fluoroscopy time was 40.5 ± 21 seconds. The overall average fluoroscopic time for placement of a single pedicle screw and per fixation level were 2.6 ± 1.7 seconds and 3.9 ± 2.5 seconds, respectively. In each surgery, the recorded radiation exposure to the surgeon was less than the minimum reportable dose. (<0.010 mSv) with an average of 0.0005 ± 0.00013 mSv per surgery.Conclusions. The use of free-hand technique for pedicle screw fixation in spinal deformity correction requires a minimum amount of fluoroscopy use, hence decreasing radiation exposure to the surgeon and patient.

PMID: 24365904 [PubMed – as supplied by publisher]