Radiation exposure and associated risks to operating-room personnel during use of fluoroscopic guidance for selected orthopaedic surgical procedures.

Abstract OBJECTIVE Exact intraoperative localization of pathologies in spinal and peripheral nerve surgery is not easily achieved. In spinal surgery, intraoperative fluoroscopy is the common method for identification of the level affected. It seldom visualizes the pathology itself and is prone to error in identifying anatomic disorders and superimposing structures. In peripheral nerve surgery, intraoperative fluoroscopy is of little value. The present technical study was conducted to evaluate the feasibility of using a preoperative computed tomography–guided needle marking system, which was previously developed for use in gynecology. The goal was to reduce intraoperative localization error and radiation exposure to patients and operating room personnel. METHODS We used a flexible hooked-wire needle marking system, which has previously been used for preoperative marking of breast lesions, to localize and tag spinal and peripheral nerve pathologies. Marking was carried out under computed tomographic control before surgery. Seven illustrative cases were chosen for this report: 6 patients with disorders of the spine and 1 patient with a peripheral nerve schwannoma. RESULTS No adverse reactions, aside from minor discomfort, were observed in this study. In all cases, the needle could be used as a reliable guide for the surgical approach and led directly to the pathology. In no case was additional intraoperative fluoroscopy needed. The level of radiation exposure to the patient as a result of computed tomography–based marking was similar to or less than that encountered in conventional intraoperative x-ray localization. Radiation exposure to the operating room personnel was eliminated by this method. CONCLUSION Preoperative marking of spinal level or peripheral nerve pathologies with a flexible hooked-wire needle marking system is feasible and appears to be safe and useful for neurosurgical spinal and peripheral procedures.

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Fluoroscopic Cranial Radiation Exposure in Spine Surgery: A Prospective Single-Center Evaluation in Operating Room Personnel

The International Journal of Spine Surgery ◽

10.14444/6004 ◽

2019 ◽

Vol 13 (1) ◽

pp. 28-32

Author(s):

LAILA MALANI MOHAMMAD ◽

JAMES MESSEGEE ◽

M. OMAR CHOHAN ◽

CHRISTOPHER L. TAYLOR

Keyword(s):

Radiation Exposure ◽

Operating Room ◽

Spine Surgery ◽

Single Center ◽

Operating Room Personnel ◽

Cranial Radiation

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Radiation exposure to the patient and operating room personnel during percutaneous nephrolithotomy

International Urology and Nephrology ◽

10.1007/s11255-005-4972-9 ◽

2006 ◽

Vol 38 (2) ◽

pp. 207-210 ◽

Cited By ~ 53

Author(s):

Geeta Kumari ◽

Pratik Kumar ◽

Pankaj Wadhwa ◽

Monish Aron ◽

Narmada P. Gupta ◽

...

Keyword(s):

Radiation Exposure ◽

Operating Room ◽

Percutaneous Nephrolithotomy ◽

Operating Room Personnel

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Intraoperative fluoroscopy, portable X-ray, and computed tomography: patient and operating room personnel radiation exposure in spinal surgery

The Spine Journal ◽

10.1016/j.spinee.2014.12.022 ◽

2015 ◽

Vol 15 (4) ◽

pp. 799-800

Author(s):

Elisha M. Nelson ◽

Shafagh M. Monazzam ◽

Kee D. Kim ◽

J. Anthony Siebert ◽

Eric O. Klineberg

Keyword(s):

Computed Tomography ◽

Radiation Exposure ◽

Operating Room ◽

Spinal Surgery ◽

Operating Room Personnel ◽

X Ray ◽

Intraoperative Fluoroscopy

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The compliance with radiation protection and knowledge about radiation exposure among the orthopedic operating room personnel in Saudi Arabia

Journal of Musculoskeletal Surgery and Research ◽

10.25259/jmsr_48_2021 ◽

2021 ◽

Vol 5 ◽

pp. 178-186

Author(s):

Abdulrahman H. Almalki ◽

Mohammad A. Almalki ◽

Rasheed S. Alballa ◽

Ibrahim S. Alshaygy ◽

Hamza M. Alrabai

Keyword(s):

Saudi Arabia ◽

Radiation Exposure ◽

Operating Room ◽

Radiation Protection ◽

Surgical Techniques ◽

Cross Sectional Study ◽

Operating Room Personnel ◽

Cross Sectional ◽

Inadequate Knowledge ◽

Radiology Technicians

Objectives: There is a rapid advancement in surgical techniques requiring real-time visualization and intraoperative X-ray utilization, leading to a higher radiation exposure among operating room (OR) staff. Taking preventive measures and reducing the unnecessary radiation exposure for the patient and the OR staff is essential. The study aimed to assess the compliance with using radiation protection equipment, as well as assessing the level of knowledge about radiation exposure among the orthopedic OR staff. Methods: This is a cross-sectional study that was conducted in Saudi Arabia. A 19-Item questionnaire that was developed and validated by Jentzsch et al. was sent to the emails of all the registered members of the Saudi Orthopedic Association, orthopedic physicians, OR nurses, and radiology technicians were included in the study. A Correlation procedure was performed to determine the relationship between knowledge and compliance scores. Results: We recruited 242 orthopedic OR personnel, 110 (45.5%) showed good knowledge and 120 (49.5%) showed good compliance. Lead apron was the most commonly used equipment, lead goggles use was the least. Females, radiology technicians, and sports and/or arthroplasty surgeons showed better compliance scores. Conclusion: The study reveals inadequate knowledge and compliance among OR staff regarding radiation protection. Therefore, we recommend providing training programs to minimize radiation hazards.

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