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Related Experiment Video

Updated: May 30, 2026

Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
05:37

Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion

Published on: August 6, 2019

Fluoroscopic exposure in modern spinal surgery.

Patrick Fransen1

  • 1Department of Neurosurgery, Clinique du Parc Léopold CHIREC, Brussels, Belgium. p.fransen@neurobrussels.be

Acta Orthopaedica Belgica
|August 18, 2011
PubMed
Summary

Minimally invasive spinal surgery significantly increases surgeon and patient radiation exposure compared to open procedures. Awareness, training, and protective measures are crucial to reduce fluoroscopy time and radiation dose during spinal operations.

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Area of Science:

  • Orthopedics
  • Neurosurgery
  • Radiology

Background:

  • Spinal procedures, including minimally invasive techniques, are increasingly common.
  • Concerns exist regarding peroperative radiation exposure for both surgeons and patients.

Purpose of the Study:

  • To prospectively evaluate fluoroscopy time and radiation dose in spinal procedures.
  • To compare radiation exposure between percutaneous and open surgical approaches.

Main Methods:

  • Prospective study of 95 spinal procedures.
  • Measurement of fluoroscopy time and radiation dose using an image amplifier.
  • Comparison of radiation dose per pedicle screw between percutaneous and open techniques.

Main Results:

  • Significant variation in radiation exposure was observed across different spinal operations.
  • Percutaneous surgery demonstrated higher radiation exposure than open surgery.
  • Average radiation dose per pedicle screw was 3.2 times higher in percutaneous insertion versus open approach.

Conclusions:

  • Minimally invasive percutaneous spinal techniques require efforts to reduce fluoroscopy time and radiation exposure.
  • Surgeon awareness, training, and adherence to preventive measures (lead protection, beam avoidance) can minimize exposure.
  • Image amplifier positioning and radiation monitoring are recommended for surgeons.

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