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Research ArticleFull Length Article
Open Access

Radiation exposure during the lateral lumbar interbody fusion procedure and techniques to reduce radiation dosage

Robert L. Tatsumi
International Journal of Spine Surgery January 2012, 6 195-199; DOI: https://doi.org/10.1016/j.ijsp.2012.09.001
Robert L. Tatsumi
Pacific Spine Specialists, PC, Tualatin, OR
MD
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  • For correspondence: rtatsumi@orspine.com
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    Fig. 1

    Mannequin with dosimeters.

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    Fig. 2

    Standard setup: AP image.

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    Fig. 3

    Standard setup: lateral image.

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    Fig. 4

    Reversed setup: lateral image.

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    Fig. 5

    Reversed setup: AP image.

Tables

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    Table 1

    Radiation dosages by scenario

    Dosimeter positionRadiation dose (mrad)SD
    SS scenario
     Eye1.60.3
     Thyroid2.61.3
     Right chest4.00.5
     Left chest3.20.7
     Right abdomen6.60.8
     Left abdomen5.80.7
    SSP scenario
     Eye0.50.07
     Thyroid0.40.0
     Right chest0.80.01
     Left chest0.60.01
     Right abdomen1.40.01
     Left abdomen1.20.01
    RS scenario
     Eye0.00.0
     Thyroid0.40.8
     Right chest0.80.2
     Left chest0.60.8
     Right abdomen1.41.3
     Left abdomen0.80.7
    • Abbreviations: RS, reversed setup; SS, standard setup; SSP, standard setup in pulsed mode.

    • View popup
    Table 2

    Comparison of 3 scenarios

    ComparisonP value
    Eye
     SS vs SSP .004
     SS vs RS< .001
     SSP vs RS .002
    Thyroid
     SS vs SSP .002
     SS vs RS .009
     SSP vs RS> .999
    Right chest
     SS vs RS<.001
     SS vs SSP< .001
     SSP vs RS .6
    Left chest
     SS vs RS< .001
     SS vs SSP< .001
     SSP vs RS .9
    Right abdomen
     SS vs RS< .001
     SS vs SSP< .001
     SSP vs RS .9
    Left abdomen
     SS vs RS< .001
     SS vs SSP< .001
     SSP vs RS .3
    • Abbreviations: RS, reversed setup; SS, standard setup; SSP, standard setup in pulsed mode.

    • View popup
    Table 3

    Number of fluoroscopically assisted cases to reach 5000 mrem

    ScenarioLateral positionPosterior positionTotal dosageCases/year
    SS6.6757
    SS + PS6.62.215.4324
    SS or RS1.43571
    SS or RS + PS1.42.23.61388
    • Abbreviations: PS, pedicle screw insertion with 1 minute of fluoroscopy when standing near intensifier7; RS, reversed setup; SS, standard setup.

    • View popup
    Table 4

    Annual exposure limits

    OrganDose (mrem/y)
    General public100
    Whole body5000
    Eye lens15,000
    Extremities and skin50,000
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International Journal of Spine Surgery
Vol. 6
1 Jan 2012
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Radiation exposure during the lateral lumbar interbody fusion procedure and techniques to reduce radiation dosage
Robert L. Tatsumi
International Journal of Spine Surgery Jan 2012, 6 195-199; DOI: 10.1016/j.ijsp.2012.09.001

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Radiation exposure during the lateral lumbar interbody fusion procedure and techniques to reduce radiation dosage
Robert L. Tatsumi
International Journal of Spine Surgery Jan 2012, 6 195-199; DOI: 10.1016/j.ijsp.2012.09.001
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