MIS vs. open TLIF radiation exposure: Which is better for spine surgery? 5 things to know

A new study published in The Journal of Spinal Disorders and Techniques examines the radiation dosage during minimally invasive transforaminal lumbar interbody fusion compared with open transforaminal lumbar interbody fusion.

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The researchers examined databases for controlled trials directly comparing minimally invasive and open TLIF. There were eight studies included in the analysis with 619 patients treated. The researchers found:

 

1. Average fluoroscopy time was 39.42 seconds for the open procedure and 94.21 seconds for the minimally invasive procedure.

 

2. The pooled data showed patients who underwent the minimally invasive surgery were exposed to 2.4-fold more radiation than those who underwent the open procedure.

 

3. The patients who underwent the open procedure were exposed to 0.66 mSv during surgery while the minimally invasive patients were exposed to 1.58 mSv during surgery.

 

4. The lifetime cancer risk was theoretically increased for the minimally invasive patients, and the risk of detrimental hereditary disorders associated with the procedures was also higher in the minimally invasive group.

 

5. The researchers concluded that even though the theoretical cancer risk associated with radiation exposure could be tolerable, “stochastic effects should not be disregarded.”

 

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Presenters: Joe Ganley, athenahealthJeffrey Flynn, CASC, Gramercy Surgery CenterBryan Tsao, Access Center, Loma Linda University HealthJason Zepeda, Northridge Hospital Medical Center, CommonSpirit HealthGreg DeConciliis, PA-C, CASC, Boston Out­Patient Surgical Suites

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