Comparison of Peri‑ operative Radiation Exposure during an Open and Miniinvasive Transpendicular Fixation of Thoracic and Lumbar Spine

Authors: T. Wanek 1;  M. Adamus 2;  V. Novák 1;  M. Homola 3
Authors‘ workplace: LF UP a FN Olomouc Neurochirurgická klinika 1;  LF UP a FN Olomouc Klinika anesteziologie a resuscitace 2;  LF UP a FN Olomouc Oddělení lékařské fyziky a radiační ochrany 3
Published in: Cesk Slov Neurol N 2013; 76/109(5): 608-613
Category: Original Paper


Radiation exposure may lead to skin cancer, leukemia or cataracts. Minimally Invasive Spine Surgery (MISS) is associated with a higher risk of Radiation Exposure (RE) due to greater use of fluoroscopy during this procedure than during open surgery. The aim of this prospective study was to assess the risk of RE for both, patients and surgeons, during spinal surgery and to compare open surgery RE to that of MISS procedures.

RE was measured throughout an18- month study period in all patients treated with transpendicular fixation (TPF). A sample of 73 patients (39 female and 34 male) was divided into two groups: Group 1 –  open surgery with 37 patients and Group 2 –  MISS with 36 patients. X‑ray was performed using spot fluoroscopy only. Total RE during a surgical procedure was recorded and the means for both groups were statistically analyzed and compared. Another measurement of RE was performed at the position of a surgeon during open and MISS surgeries (each group consisted of five surgeries) using a special device for detection of radiation.

The authors found statistically significantly higher RE in Group 2 (ø 6.3 mSv × cm2) compared to Group 1 (ø 3.2 mSv × cm2).

Despite observed statistical significance, RE during MISS was still very low and did not exceed the annual exposure limits even at high frequency of surgeries. Therefore, intraoperative RE should not be the reason for limiting this type of spinal surgery.

Key words:
thoracic and lumbar spine – minimally invasive spine surgery – radiation exposure –transpedicular fixation

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


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