Radiation exposure during scoliosis surgery: a prospective study

Abstract

Background context: The present literature on the cancer risks related to radiation exposure in patients and surgeons during scoliosis surgery is sparse.

Purpose: To assess the radiation exposure in patients and surgeons during scoliosis surgery and estimate the increased cancer risk of both groups.

Study design: Over a 6-month period, we conducted a prospective study to monitor the intraoperative radiation dose received by both patients and surgeons during scoliosis cases.

Patient sample: It included 30 consecutive patients undergoing scoliosis surgery by a team of two surgeons (S1 and S2).

Outcome measures: We measured the radiation exposure to the eyes, thyroid, and hands for each surgeon; measured the difference of radiation exposure between the two surgeons; the difference in radiation exposure with respect to the proximity of the surgeon to the X-ray tube, and the radiation exposure for each patient.

Methods: An electronic dosimeter was attached over the thyroid guard and a thermoluminescent dosimeter ring on both hands of each surgeon. The patients were monitored using the dose area product (DAP) measurements from the image intensifier, and their radiation exposure was calculated with the Monte Carlo calculation.

Results: The mean eye dose per procedure for the two surgeons S1 and S2 was 0.8 μSv and 1.3 μSv, respectively. The mean thyroid dose for S2 and S1 was 1.2 μSv and 1.4 μSv, respectively. The dose recorded by the surgeon on the same side of the patient as the X-ray tube was significantly higher than for the surgeon on the far side (p<.05). Mean DAP per procedure was 91.3 cGycm(2) and the mean radiation dose for patients was 252.9 μSv. The increase in cancer risk for patients and surgeons was 0.001% and 0.0005%, respectively, for each year of exposure.

Conclusions: A significantly higher dose of radiation during scoliosis surgery was received by the surgeon standing on the same side as the X-ray tube. However, both surgeons received a total radiation dose of less than 1% of the recommended dose limit per year and, therefore, the total radiation exposure in both surgeons and patients was well within the recommended safe limits.

Keywords: Cancer risk; Children; Radiation exposure; Radiation protection; Scoliosis surgery; Surgeon.