More Radiation in Minimally Invasive Than Open Surgery

Standing in a substerile room during X-ray screening in open cases is only partially protective

MONDAY, Feb. 7 (HealthDay News) -- Surgeons are exposed to significantly more radiation during minimally invasive lumbar microdiscectomy compared to traditional open microdiscectomy, according to a study published in the Feb. 1 issue of Spine.

Michael W. Mariscalco, M.D., of the Cleveland Clinic, and colleagues carried out a prospective in vivo study to analyze radiation exposure to the surgeon in 10 minimally invasive lumbar microdiscectomy surgeries compared with 10 traditional open discectomy cases. Radiation exposure to the surgeon was measured in millirads (mR) per case using digital dosimeters placed at the levels of the thyroid/eye, chest, and dominant forearm.

The investigators found that the average radiation exposure to the surgeon in minimally invasive cases was 1.72 ± 1.52 mR to the thyroid/eye, 3.08 ± 2.93 mR to the chest, and 4.45 ± 3.75 mR to the arm. These results show a significant increase compared with open discectomy cases in which radiation exposure was 0.16 ± 0.22 mR to the thyroid/eye, 0.21 ± 0.23 mR to the chest, and 0.20 ± 0.14 mR to the arm. Surgeons who stood in an adjacent substerile room during open cases were exposed to 0.2 mR per case.

"The principle findings of this study indicate that MIS [minimally invasive surgery] lumbar microdiscectomy exposes a surgeon to significantly more radiation than the traditional open technique," the authors write. "It is, therefore, recommended that steps be taken to monitor and limit exposure for each case for all persons of the surgical team for both MIS and open cases."

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