Intra-operative fluoroscopy exposure in endoscopic lumbar discectomies

Area of Science:

• Minimally Invasive Spine Surgery
• Medical Imaging
• Radiation Safety

Background:

• Spinal endoscopic procedures utilize fluoroscopy for instrumentation guidance.
• Fluoroscopy exposes medical staff and patients to ionizing radiation.
• Evaluating radiation doses in endoscopic lumbar discectomy is crucial for safety.

Purpose of the Study:

• To assess and compare radiation doses during interlaminar endoscopic lumbar discectomy (IELD) and transforaminal endoscopic lumbar discectomy (TELD).
• To analyze patient-specific and radiation-related variables for both procedures.

Main Methods:

• A retrospective analysis of 54 patients undergoing IELD (n=18) or TELD (n=36) for lumbar disc herniations.
• Data collected included patient demographics and radiation metrics: fluoroscopy time (FT), tube voltage (kVp), kerma-area product (KAP), and cumulative air-kerma (CAK).

Main Results:

• Significant differences observed in age, procedure duration, cine acquisitions, FT, KAP, and CAK between IELD and TELD groups.
• Mean KAP was 8.18 dGycm² for IELD vs. 29.09 dGycm² for TELD.
• Mean FT was 18.72 s for IELD vs. 54.94 s for TELD; skin doses remained below safe thresholds.

Conclusions:

• Intra-operative fluoroscopy during endoscopic discectomy yields low radiation doses.
• Radiation dose data were comparable between IELD and TELD techniques.
• TELD procedures necessitate longer fluoroscopy times and are more demanding.