Radiation Exposure to the Surgeon and Patient During a Fluoroscopic Procedure: How High Is the Exposure Dose? A Cadaveric Study

Spine (Phila Pa 1976). 2016 Aug 1;41(15):1254-1260. doi: 10.1097/BRS.0000000000001542.


Study design: Using fresh cadavers, real-time dosimeters were used to estimate the radiation exposure dose from C-arm fluoroscopy to surgeons, medical staff, and patients during various procedures.

Objective: The aim of this study was to evaluate the radiation exposure dose from C-arm fluoroscopy, which is used to generate real-time images of the human body, under a variety of conditions and in different areas.

Summary of background data: Awareness of the harmful effects of long-term low-dose radiation is rising. There are no all-inclusive reports evaluating the radiation exposure dose to medical staff associated with fluoroscopic procedures that can accurately simulate the real clinical situation.

Methods: Seven fresh cadavers were irradiated for 1, 3, and 5 minutes with C-arm fluoroscopy. The x-ray source was positioned under the table, over the table, and laterally. Radiation exposure doses were measured at different simulated areas such as the center area, and the surgeon's hand or thyroid gland.

Results: There were significant differences in the radiation exposure dose under different conditions and for different irradiated areas. The risk of direct and scatter radiation exposure was the greatest with the lateral position, which increased by more than 200 times and more than 30 times, respectively, compared with that from a position under the table. Direct radiation was attenuated to less than one-hundredth after passing through the body of the cadaver. All radiation exposure doses were positively correlated with total exposure time.

Conclusion: Our study revealed the direct and scatter radiation exposure dose from C-arm fluoroscopy to different areas under a variety of conditions when fluoroscopy is used to generate real-time images of the human body. Our results serve as a guide for medical staff to understand the risk of radiation exposure during each fluoroscopic procedure. Medical staff, especially surgeons, should consider how to protect themselves and reduce radiation exposure by using appropriate shielding.

Level of evidence: 4.

MeSH terms

  • Cadaver
  • Fluoroscopy*
  • Humans
  • Occupational Exposure / statistics & numerical data*
  • Patients
  • Radiation Dosage*
  • Radiation Exposure / statistics & numerical data*
  • Radiation Injuries / prevention & control
  • Radiation Injuries / therapy
  • Radiation Protection / statistics & numerical data
  • Surgeons