Literature DB >> 29396814

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

Kazuyoshi Kobayashi1, Kei Ando1, Kenyu Ito1, Mikito Tsushima1, Masayoshi Morozumi1, Satoshi Tanaka1, Masaaki Machino1, Kyotaro Ota1, Naoki Ishiguro1, Shiro Imagama2.   

Abstract

PURPOSE: The O-arm® navigation system allows intraoperative CT imaging that can facilitate highly accurate instrumentation surgery, but radiation exposure is higher than with X-ray radiography. This is a particular concern in pediatric surgery. The purpose of this study is to examine intraoperative radiation exposure in pediatric spinal scoliosis surgery using O-arm.
METHODS: The subjects were 38 consecutive patients (mean age 12.9 years, range 10-17) with scoliosis who underwent spinal surgery with posterior instrumentation using O-arm. The mean number of fused vertebral levels was 11.0 (6-15). O-arm was performed before and after screw insertion, using an original protocol for the cervical, thoracic, and lumbar spine doses.
RESULTS: The average scanning range was 6.9 (5-9) intervertebral levels per scan, with 2-7 scans per patient (mean 4.0 scans). Using O-arm, the dose per scan was 92.5 (44-130) mGy, and the mean total dose was 401 (170-826) mGy. This dose was 80.2% of the mean preoperative CT dose of 460 (231-736) mGy (P = 0.11). The total exposure dose and number of scans using intraoperative O-arm correlated strongly and significantly with the number of fused levels; however, there was no correlation with the patient's height.
CONCLUSIONS: As the fused range became wider, several scans were required for O-arm, and the total radiation exposure became roughly the same as that in preoperative CT. Use of O-arm in our original protocol can contribute to reduction in radiation exposure.

Entities:  

Keywords:  CT scan; Cancer risk; Image quality; Low-dose protocol; O-arm; Pediatrics; Radiation dose; Radiation exposure; Scoliosis; Screw insertion

Mesh:

Year:  2018        PMID: 29396814     DOI: 10.1007/s00590-018-2130-1

Source DB:  PubMed          Journal:  Eur J Orthop Surg Traumatol        ISSN: 1633-8065


  29 in total

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Journal:  Clin Spine Surg       Date:  2017-07       Impact factor: 1.876

2.  Diagnostic x-ray procedures and risk of leukemia, lymphoma, and multiple myeloma.

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3.  Cancer mortality among women frequently exposed to radiographic examinations for spinal disorders.

Authors:  Cécile M Ronckers; Charles E Land; Jeremy S Miller; Marilyn Stovall; John E Lonstein; Michele M Doody
Journal:  Radiat Res       Date:  2010-07       Impact factor: 2.841

4.  Increased cancer risk among surgeons in an orthopaedic hospital.

Authors:  Giuseppe Mastrangelo; Ugo Fedeli; Emanuela Fadda; Angelo Giovanazzi; Luca Scoizzato; Bruno Saia
Journal:  Occup Med (Lond)       Date:  2005-09       Impact factor: 1.611

5.  Breast cancer mortality after diagnostic radiography: findings from the U.S. Scoliosis Cohort Study.

Authors:  M M Doody; J E Lonstein; M Stovall; D G Hacker; N Luckyanov; C E Land
Journal:  Spine (Phila Pa 1976)       Date:  2000-08-15       Impact factor: 3.468

6.  Managing patient dose in multi-detector computed tomography(MDCT). ICRP Publication 102.

Authors:  J Valentin
Journal:  Ann ICRP       Date:  2007

7.  Breast cancer in women with scoliosis exposed to multiple diagnostic x rays.

Authors:  D A Hoffman; J E Lonstein; M M Morin; W Visscher; B S Harris; J D Boice
Journal:  J Natl Cancer Inst       Date:  1989-09-06       Impact factor: 13.506

8.  Intraoperative fluoroscopy, portable X-ray, and CT: patient and operating room personnel radiation exposure in spinal surgery.

Authors:  Elisha M Nelson; Shafagh M Monazzam; Kee D Kim; J Anthony Seibert; Eric O Klineberg
Journal:  Spine J       Date:  2014-06-07       Impact factor: 4.166

9.  Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians.

Authors:  John D Mathews; Anna V Forsythe; Zoe Brady; Martin W Butler; Stacy K Goergen; Graham B Byrnes; Graham G Giles; Anthony B Wallace; Philip R Anderson; Tenniel A Guiver; Paul McGale; Timothy M Cain; James G Dowty; Adrian C Bickerstaffe; Sarah C Darby
Journal:  BMJ       Date:  2013-05-21

10.  Utility of a Computed Tomography-Based Navigation System (O-Arm) for En Bloc Partial Vertebrectomy for Lung Cancer Adjacent to the Thoracic Spine: Technical Case Report.

Authors:  Kazuyoshi Kobayashi; Shiro Imagama; Zenya Ito; Kei Ando; Kohei Yokoi; Naoki Ishiguro
Journal:  Asian Spine J       Date:  2016-04-15
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  3 in total

1.  A novel technique of cervical pedicle screw placement with a pilot screw under the guidance of intraoperative 3D imaging from C-arm cone-beam CT without navigation for safe and accurate insertion.

Authors:  Masahiko Takahata; Katsuhisa Yamada; Iwata Akira; Tsutomu Endo; Hideki Sudo; Hidetoki Yokoyama; Norimasa Iwasaki
Journal:  Eur Spine J       Date:  2018-07-23       Impact factor: 3.134

2.  Intraoperative 3D Imaging Reduces Pedicle Screw Related Complications and Reoperations in Adolescents Undergoing Posterior Spinal Fusion for Idiopathic Scoliosis: A Retrospective Study.

Authors:  Antti J Saarinen; Eetu N Suominen; Linda Helenius; Johanna Syvänen; Arimatias Raitio; Ilkka Helenius
Journal:  Children (Basel)       Date:  2022-07-28

3.  Posterior percutaneous endoscopic cervical foraminotomy and discectomy for degenerative cervical radiculopathy using intraoperative O-arm imaging.

Authors:  Wei Shu; Hongwei Zhu; Ruicun Liu; Yongjie Li; Tao Du; Bin Ni; Haipeng Wang; Tao Sun
Journal:  Wideochir Inne Tech Maloinwazyjne       Date:  2019-10-17       Impact factor: 1.195

  3 in total

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