Related Experiment Video
Updated: Jun 21, 2026
Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
Published on: October 14, 2022
Patient and physician radiation exposure during minimally invasive lumbar decompression: A prospective assessment of
Nagy Mekhail1, Krista Topalsky2, Erin Templeton1
1Pain Management Department, Cleveland Clinic, Cleveland, Ohio, USA.
Introduction:
Minimally invasive lumbar decompression (mild®) is becoming a popular procedure for treating lumbar spinal stenosis (LSS) secondary to hypertrophic ligamentum flavum (LF). The mild® procedure is commonly performed under live fluoroscopic guidance and carries a risk of radiation exposure to the patient and healthcare.
Methods:
One physician performed mild® on 41 patients at the Cleveland Clinic Department of Pain Management from October 2019 to December 2021, while wearing a radiation exposure monitor (Mirion Technologies). Mean fluoroscopy time, mean exposure per case, and mean exposure per unilateral level decompressed were the primary outcomes measured. The secondary outcome was to provide a comparison of radiation exposure during similar fluoroscopically guided procedures.
Results:
Mean patient fluoroscopy exposure time was 2.1 min ±0.9 (range: 1.1-5.6) fluoroscopy time per unilateral level decompressed. The mean patient radiation skin exposure from mild® was 1.1 ± 0.9 mGym2, and the mean total dose was 142.3 ± 108.6 mGy per procedure. On average, the physician was exposed to an average deep tissue exposure of 4.1 ± 3.2 mRem, 2.9 ± 2.2 mRem estimated eye exposure, and 14.7 ± 11.0 mRem shallow tissue exposure per unilateral level decompressed. An individual physician would exceed the annual exposure limit of 5 Rem after approximately 610 mild® procedures per year.
Conclusions:
This study is an attempt to quantify the radiation exposure to the physician and patient during the mild® procedure. Compared with other fluoroscopically guided pain management procedures, patient and physician radiation exposure during mild® was low.
Insights
Minimally invasive lumbar decompression (mild®) for spinal stenosis shows low radiation exposure for patients and physicians. This fluoroscopic procedure
Area of Science:
- Interventional Pain Management
- Neurosurgery
- Radiology
Background:
- Minimally invasive lumbar decompression (mild®) is a growing treatment for lumbar spinal stenosis (LSS).
- The procedure utilizes fluoroscopic guidance, posing potential radiation risks.
- Hypertrophic ligamentum flavum is a common cause of LSS addressed by mild®.
Purpose of the Study:
- To quantify patient and physician radiation exposure during the mild® procedure.
- To compare radiation exposure from mild® to other fluoroscopically guided interventions.
Main Methods:
- A single physician performed mild® on 41 patients between October 2019 and December 2021.
- Physician radiation exposure was monitored using a dosimeter.
- Key metrics included fluoroscopy time and radiation dose per procedure and per level.
Main Results:
- Mean patient fluoroscopy time was 2.1 minutes per unilateral level.
- Mean patient radiation skin exposure was 1.1 mGy/cm².
- Physician exposure was low, with annual limits unlikely to be exceeded after 610 procedures.
Conclusions:
- Radiation exposure for both patients and physicians during the mild® procedure is minimal.
- Compared to similar procedures, mild® demonstrates favorable radiation safety profiles.
More Related Videos
04:42Clinical Application of Microscope-Assisted Minimally Invasive Anterior Lumbar Interbody Fusion
Published on: June 16, 2023
04:33Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
Published on: November 8, 2024
