RADIATION EXPOSURE DURING SPINE SURGERY USING C-ARM FLUOROSCOPY

ABSTRACT Objective: To evaluate the radiation dose received by staff in spine surgeries, including those who are not considered occupationally exposed workers. Methods: All spinal surgeries performed in the same department during a period of 12 months were evaluated with regard to the exposure of surgeons, scrub nurses, and auxiliary personnel working in the operating room to radiation from C-arm fluoroscopy. Radiation was measured by 15 film badge dosimeters placed on the professionals’ lapels, gloves, and room standardized sites. The films were analyzed in the dosimetry laboratory by collections per period. Results: During the 12 months, 81 spinal surgeries were performed by the same team, with surgical times ranging from 1 to 6 hours. The total radiation dose ranged from 0.16 mSv to 2.29 mSv depending on the dosimetry site. The most exposed site was the wrist of the main surgeon. Conclusion: The results showed that in the spinal surgeries in our setting, the radiation doses are low and within legal limits. Nevertheless, constant training of professionals is essential for radiation protection of medical staff and patients. Level of evidence I/b, exploratory cohort study.

摘要
研究目的：评估脊柱手术中医护人员所受辐射剂量，包括未被归类为职业暴露人群的人员。
研究方法：对同一科室12个月内开展的全部脊柱手术进行评估，分析手术室中医师、器械护士及辅助人员所受C臂透视（C-arm fluoroscopy）辐射暴露情况。通过在医护人员衣领、手套及手术室标准化点位放置15个胶片剂量计（film badge dosimeters）进行辐射剂量测量，按周期收集胶片后送至剂量学实验室开展分析。
研究结果：12个月内该手术团队共完成81台脊柱手术，手术时长1至6小时不等。不同监测点位的总辐射剂量范围为0.16 mSv至2.29 mSv，受辐射剂量最高的点位为主刀医师的手腕。
研究结论：本研究所在机构开展的脊柱手术中，医护人员所受辐射剂量较低，处于法定限值范围内。但为保障医护人员与患者的辐射防护，持续开展专业培训至关重要。
本研究为探索性队列研究，证据等级为I/b。