PATIENT SIZE INDICES AND DOSE IN FLUOROSCOPICALLY GUIDED LUMBAR DISCECTOMY AND FUSION: A PRELIMINARY STUDY.

Patient dose values varied significantly during interventional procedures, mainly due to the patient size, operators' choices and clinical complexity. In this study, the effect of applying a previously described and validated size-correction method to normalise kerma-area product (KAP) and average KAP rate values of the whole procedure (KAP rate) and isolate variations in dose due to the patient size and complexity, during lumbar discectomy and fusion (LDF) procedures, was investigated. Fluoroscopy time (FT), KAP, KAP rate and patient size data (weight, height and equivalent diameter) were recorded, for 96 patients who underwent single or multilevel LDF procedures by three senior neurosurgeons, defining three different patient groups (surgeon 1, surgeon 2, surgeon 3).

DO THE BMI AND SURGEON INFLUENCE THE PATIENT DOSE IN FLUOROSCOPICALLY GUIDED LUMBAR DISCECTOMY AND FUSION?☆.

A survey was conducted to evaluate the role of the surgeon and the patients' body size, on patient radiation dose in fluoroscopically guided lumbar discectomy and fusion (LDF) procedures. Fluoroscopy time (FT), kerma area product (KAP), cumulative dose (CD), as well as anatomical and technical data were recorded for 100 patients, who underwent single or multi-level posterior LDF, which was carried out by three senior neurosurgeons utilising a C-arm fluoroscopy system. The patients were divided into three groups based on the body mass index (BMI) values (normal, overweight, obese) and the neurosurgeon that performed each procedure (surgeon 1, surgeon 2, surgeon 3).

OPTIMISATION OF PATIENT DOSE AND IMAGE QUALITY IN FLUOROSCOPICALLY GUIDED CERVICAL SPINE SURGERY: A PHANTOM-BASED STUDY.

The purpose of the current study was to provide useful data, which may help neurosurgeons to manage the patient dose and image quality in spinal surgery procedures, utilising a phantom and a test object. The kerma area product, cumulative dose (CD) and entrance surface dose (ESD) rate on the phantom and image intensifier were measured, for selectable fields of view (FOVs), fluoroscopy modes, two geometric magnifications and various phantom thicknesses. The images were subjectively evaluated regarding low-contrast detectability and high-contrast resolution.

Institutional (local) diagnostic reference levels in fluoroscopically guided spine surgery.

In this study, institutional (local) diagnostic reference levels (LDRLs) and action levels (ALs) for spine interventional procedures are reported. Fluoroscopy time (FT), kerma area product (KAP), cumulative dose (CD), as well as anatomical, clinical and technical factors affecting procedure complexity were recorded for 156 patients who underwent cervical and thoraco-lumbar interventions. Patient entrance surface dose (ESD), effective dose (ED), thyroid absorbed dose and gonadal dose were also estimated, based on KAP measurements.

Patient Dose in Fluoroscopically Guided Cervical Discectomy and Fusion.

Cervical discectomy and fusion (CDF) is a minimally invasive procedure, where the accurate placement of the implants is accomplished using fluoroscopic guidance. Therefore, the evaluation of the radiation dose becomes mandatory. The purpose of the current study was to assess patient dose during fluoroscopically guided anterior and/or posterior CDF procedures.