Occupational Radiation Exposure During Intraoperative 3-Dimensional Fluoroscopy in Pelvis and Acetabular Surgery.

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Radiation Safety

Background:

• Intraoperative imaging is crucial for complex orthopedic procedures.
• Three-dimensional (3D) fluoroscopy offers enhanced visualization but raises concerns about radiation exposure.
• Pelvic and acetabular surgeries often require extensive intraoperative imaging.

Purpose of the Study:

• To quantify occupational radiation exposure during 3D fluoroscopy in pelvic and acetabular surgery.
• To assess if the radiation dose from the 3D fluoroscopic spin is within established safety limits.
• To evaluate the safety of utilizing 3D fluoroscopy in orthopedic operating rooms.

Main Methods:

• Prospective cohort study conducted at a Level I trauma center.
• Inclusion of all patients undergoing 3D fluoroscopy for pelvic or acetabular surgery.
• Measurement of radiation dose at standardized locations during the 3D fluoroscopic spin phase.

Main Results:

• Seventy-six 3D spins were performed on 69 patients.
• The average displayed radiation dose during the spin was 39.9 mGy, 53.6% less than routine fluoroscopy.
• Average patient exposure was 3.42 mGy, with maximal room exposure at 0.062 mGy; minimal radiation detected outside the OR.

Conclusions:

• Occupational radiation exposure from 3D fluoroscopy in these surgeries is within safe limits.
• The radiation increase associated with 3D imaging is marginal and acceptable.
• The use of intraoperative 3D fluoroscopy in pelvic and acetabular surgery is encouraged.