Literature DB >> 28632552

Comparative Study of C-Arms for Intraoperative 3-dimensional Imaging and Navigation in Minimally Invasive Spine Surgery Part II: Radiation Exposure.

Jan-Helge Klingler1, Ronen Sircar, Christian Scheiwe, Evangelos Kogias, Marie T Krüger, Christoph Scholz, Ulrich Hubbe.   

Abstract

STUDY
DESIGN: A radiation exposure study in vitro.
OBJECTIVE: This study aimed to compare the radiation exposure of 2 different 3-dimensional (3D) C-arm devices on an anthropomorphic phantom. SUMMARY OF BACKGROUND DATA: Minimally invasive pedicle screw placement requires intraoperative imaging techniques for visualization of the unexposed spine. Mobile 3D C-arms compose a 3D image data set out of multiple successive fluoroscopic images.
METHODS: We compared the 3D C-arm devices Siremobil Iso-C 3D (Siemens Sector Healthcare, Erlangen, Germany) and Vision FD Vario 3D (Ziehm Imaging, Nuremberg, Germany) regarding their radiation exposure. For this purpose, dosimeters were attached on an anthropomorphic phantom at various sites (eye lenses, thyroid gland, female, and male gonads). With each C-arm, 10 automated 3D scans as well as 400 fluoroscopic images were performed on the cervical and lumbar spine, respectively.
RESULTS: The Vision FD Vario 3D generally causes higher radiation exposures than the Siremobil Iso-C 3D. Significantly higher radiation exposures were assessed at the eye lenses performing cervical (294.1 vs. 84.6 μSv) and lumbar 3D scans (22.5 vs. 11.2 μSv) as well as at the thyroid gland performing cervical 3D scans (4405.2 vs. 2761.9 μSv). Moreover, the Vision FD Vario 3D caused significantly higher radiation exposure at the eye lenses for standard cervical fluoroscopic images (3.2 vs. 0.4 μSv).
CONCLUSIONS: 3D C-arms facilitate minimally invasive and accurate pedicle screw placement by providing 3D image datasets for intraoperative 3D imaging and navigation. However, the hereby potentially increased radiation exposure has to be considered. In particular, the Vision FD Vario 3D appears to generally evoke higher radiation exposures than the Siremobil Iso-C 3D. Well-indicated application of ionizing radiation and compliance with radiation protection principles remain mandatory to keep radiation exposure to patient and staff as low as reasonably achievable.

Entities:  

Mesh:

Year:  2017        PMID: 28632552     DOI: 10.1097/BSD.0000000000000187

Source DB:  PubMed          Journal:  Clin Spine Surg        ISSN: 2380-0186            Impact factor:   1.876


  8 in total

Review 1.  Computer-assisted Surgery for Scaphoid Fracture.

Authors:  Zi-Run Xiao; Ge Xiong
Journal:  Curr Med Sci       Date:  2018-12-07

2.  Safe placement of pedicle screw in lumbar spine with minimum three year follow-up: a case series and technical note.

Authors:  Di Zhang; Xianda Gao; Jiang Jiang; Yong Shen; Wenyuan Ding; Huixian Cui
Journal:  Int Orthop       Date:  2018-02-02       Impact factor: 3.075

3.  Intraoperative radiation exposure in spinal scoliosis surgery for pediatric patients using the O-arm® imaging system.

Authors:  Kazuyoshi Kobayashi; Kei Ando; Kenyu Ito; Mikito Tsushima; Masayoshi Morozumi; Satoshi Tanaka; Masaaki Machino; Kyotaro Ota; Naoki Ishiguro; Shiro Imagama
Journal:  Eur J Orthop Surg Traumatol       Date:  2018-02-02

4.  Minimally Invasive Technique for PMMA Augmentation of Fenestrated Screws.

Authors:  Jan-Helge Klingler; Christoph Scholz; Evangelos Kogias; Ronen Sircar; Marie T Krüger; Florian Volz; Christian Scheiwe; Ulrich Hubbe
Journal:  ScientificWorldJournal       Date:  2015-05-14

5.  Surgeon, staff, and patient radiation exposure in minimally invasive transforaminal lumbar interbody fusion: impact of 3D fluoroscopy-based navigation partially replacing conventional fluoroscopy: study protocol for a randomized controlled trial.

Authors:  Ulrich Hubbe; Ronen Sircar; Christian Scheiwe; Christoph Scholz; Evangelos Kogias; Marie Therese Krüger; Florian Volz; Jan-Helge Klingler
Journal:  Trials       Date:  2015-04-09       Impact factor: 2.279

Review 6.  Radiation exposure and reduction in the operating room: Perspectives and future directions in spine surgery.

Authors:  Ankur S Narain; Fady Y Hijji; Kelly H Yom; Krishna T Kudaravalli; Brittany E Haws; Kern Singh
Journal:  World J Orthop       Date:  2017-07-18

7.  Evolving Navigation, Robotics, and Augmented Reality in Minimally Invasive Spine Surgery.

Authors:  Ibrahim Hussain; Murat Cosar; Sertac Kirnaz; Franziska A Schmidt; Christoph Wipplinger; Taylor Wong; Roger Härtl
Journal:  Global Spine J       Date:  2020-05-28

8.  Radiation exposure of a mobile 3D C-arm with large flat-panel detector for intraoperative imaging and navigation - an experimental study using an anthropomorphic Alderson phantom.

Authors:  Yashar Naseri; Ulrich Hubbe; Christoph Scholz; Johannes Brönner; Marie T Krüger; Jan-Helge Klingler
Journal:  BMC Med Imaging       Date:  2020-08-14       Impact factor: 1.930

  8 in total

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