Radiation exposure to the surgeon during pedicle screw placement with the freehand technique is greater than with the use of navigation, according to study published in Spine.
Here are five things to know about the study and radiation exposure during pedicle screw placement:
1. The objective of the study was to compare occupational radiation exposure to the surgeon as well as the patient during posterior lumbar spine instrumentation in 10 navigated cases versus 11 cases using the freehand technique or non-navigated cases.
2. Radiation exposure to the surgeon was measured by digital dosimeters placed at the level of the eye, chest and dominant forearm. Radiation exposure was measured from the time of positioning of the patient to the end of the procedure both for navigated, fluoroscopy-based and non-navigated, fluoroscopy-guided freehand posterior lumbar spine instrumentations.
A 3-D fluoroscopic scan was routinely performed at the end of the procedure for all patients.
3. The accumulated radiation dose for the surgeon was significantly higher in the non-navigated group — up to 9.96 times. The radiation dose for the patient was higher with the freehand technique — 1884.8 cGy•cm2 during non-navigated techniques versus 887 cGy•cm2 during navigated techniques. Neuronavigation reduces the cumulative dose for the patient, noted the study authors.
4. In an article published in Spine in March, researchers reported results of a study evaluating whether freehand pedicle screw fixation in pediatric spinal deformity correction reduced surgeon radiation exposure.
The study found that to place a single screw, average fluoroscopy time was 2.6±1.7 seconds. Researchers recorded less radiation exposure than the minimum reportable dose in each surgery.
"The use of freehand technique for pedicle screw fixation in spinal deformity correction requires a minimum amount of fluoroscopic use, hence decreasing radiation exposure to the surgeon and patient," the study authors concluded.
5. It has been found that the use fluoroscopic navigation increases the accuracy of pedicle screw placement. A study published in The Spine Journal in April showed that intraoperative use of fluoroscopy, especially in the anterioposterior position, significantly decreased the risk of screw misplacement.