Lasya Daggumati - Department of Interventional Radiology
Surgeons are at higher risk for radiation damage than we think due to unnecessary radiation exposure despite generally safe radiation levels. This paper investigates the radiation exposure of surgeons during minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) surgeries. MIS-TLIF is a muscle-dilating approach that has gained popularity in the treatment of degenerative lumbar disease. It offers advantages such as reduced blood loss, narcotic use, hospital stay, work time loss, infection rates, and improved postoperative outcomes. The study found that the radiation exposure to the operating surgeon's right middle finger was significantly higher compared to other measured body parts. However, the overall radiation exposure for the surgeons during MIS-TLIF was considered safe according to the guidelines of the International Commission on Radiological Protection. The findings highlight the importance of monitoring the accumulated radiation exposure.
Previous studies have reported a range of doses to surgeons' hands during procedures, and the concern arises from the potential for acute and chronic skin damage, as well as the risk of radiation-induced cancer. It is recommended to maintain a certain distance from the X-ray beam, using long Kocher clamps during fluoroscopy shots to distance the hands from the X-ray tube, and being mindful of hand location during procedures. Wearing a lead apron and thyroid collar was found to reduce radiation exposure. The use of a one-shot fluoroscopic technique was considered a key factor in reducing radiation exposure. The findings highlight the need for basic precautions to minimize radiation exposure during MIS-TLIF procedures or any other procedures that utilize radiation. There is a greater necessity for the development of lower-radiation alternatives or improved protective equipment in the future.
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