A new study published in The Spine Journal examines radiation exposure for patients undergoing CT navigation spinal instrumentation compared with conventional fluoroscopy.
The researchers examined 73 patients who underwent CT navigated spinal instrumentation and 73 patients who underwent the conventional fluoroscopy. The average navigated operations involved 5.44 levels. Here are five key notes from the study:
1. The thoracic and lumbar spines reported higher radiation admission from the CT, X-ray and fluoroscopy when compared with cervical cases—6.93 mSv compared with 2.34 mSv.
2. The patients with major deformity and degeneration were exposed to more radiation — 7.05 mSv — when compared with trauma or oncology cases — 4.2 mSv.
3. The total radiation dose to patients was 8.7 times more than the radiation emitted when the surgical team was inside the operating room. The total patient radiation exposure was 2.77 times the values reported in the literature for thoracolumbar instrumentation without navigation.
4. The radiation emitted to patients when the surgical team was in the operating room was 2.5 lower than non-navigated thoracolumbar instrumentation, with the average total radiation exposure to the patients at 5.69 mSv. The value was less than a single routine lumbar CT at 7.5 mSv.
5. Radiation exposure to the patient on average in the study was around one-quarter the recommended annual occupational radiation exposure level, and the navigation didn't reduce the number of postoperative X-rays or CT scans.
"Surgeons should be aware of the radiation exposure implications to both the patient and surgical team when using intraoperative CT navigation," concluded the study authors.