دورية أكاديمية
Radiation exposure in navigated techniques for AIS: is there a difference between pre-operative CT and intraoperative CT?
العنوان: | Radiation exposure in navigated techniques for AIS: is there a difference between pre-operative CT and intraoperative CT? |
---|---|
المؤلفون: | Sullivan MH; Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA., Yu L; Department of Radiology, Mayo Clinic, Rochester, MN, USA., Schueler BA; Department of Radiology, Mayo Clinic, Rochester, MN, USA., Nassr A; Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA., Guerin J; Department of Radiology, Mayo Clinic, Rochester, MN, USA., Milbrandt TA; Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA., Larson AN; Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. larson.noelle@mayo.edu. |
المصدر: | Spine deformity [Spine Deform] 2024 Mar; Vol. 12 (2), pp. 349-356. Date of Electronic Publication: 2023 Oct 23. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Springer Nature Country of Publication: England NLM ID: 101603979 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2212-1358 (Electronic) Linking ISSN: 2212134X NLM ISO Abbreviation: Spine Deform Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2020- : London : Springer Nature Original Publication: New York, N.Y. : Elsevier |
مواضيع طبية MeSH: | Scoliosis*/diagnostic imaging , Scoliosis*/surgery , Scoliosis*/etiology , Surgery, Computer-Assisted*/methods , Kyphosis*/etiology , Radiation Exposure*, Adolescent ; Humans ; Cohort Studies ; Imaging, Three-Dimensional ; Tomography, X-Ray Computed/methods |
مستخلص: | Purpose: Utilization of navigation improves pedicle screw accuracy in adolescent idiopathic scoliosis (AIS). Our center switched from intraoperative CT (ICT) to an optical navigation system that utilizes pre-operative CT (PCT). We aim to evaluate the radiation dose and operative time for low-dose ICT compared to standard and low-dose PCT used for optical navigation in AIS patients undergoing posterior spinal fusion. Methods: A single-center matched-control cohort study of 38 patients was conducted. Nineteen patients underwent ICT navigation (O-arm) and were matched by sex, age, and weight to 19 patients who underwent PCT for use with an optical-guided navigation (7D, Seaspine). A total of 418 levels were instrumented and reviewed. PCT was either a standard dose (N = 7) or a low dose (N = 12). The mean volume CT dose index, dose-length product, overall effective dose (ED), ED per level instrumented, and operative time per level were compared. Results: ED per level instrumented was 0.061 ± 0.029 mSv in low-dose PCT and 0.14 ± 0.05 mSv in low-dose ICT (p < 0.0001). ED per level instrumented was significantly higher in standard PCT (1.46 ± 0.39 vs. 0.14 ± 0.03 mSv; p < 0.0001). Mean operative time per level was 31 ± 7 min for ICT and 33 ± 3 min for PCT (p = 0.628). Conclusion: Low-dose PCT resulted in 0.70 mSv exposure per case and 31 min per level, standard-dose was 16.95 mSv, while ICT resulted in 1.34-1.62 mSv and a similar operative time. Use of a standard-dose PCT involves radiation exposure about 9 times higher than ICT and 23 times higher than low-dose PCT per level instrumented. Level of Evidence: Level III. (© 2023. The Author(s), under exclusive licence to Scoliosis Research Society.) |
References: | Erickson MM, Currier BL (2012) Surgical management of complex spinal deformity. Orthop Clin North Am 43(1):109–122 (ix). (PMID: 10.1016/j.ocl.2011.10.00122082634) Larson AN et al (2019) Minimum 20-year health-related quality of life and surgical rates after the treatment of adolescent idiopathic scoliosis. Spine Deform 7(3):417–427. (PMID: 10.1016/j.jspd.2018.09.00331053312) Chan A et al (2017) Intraoperative image guidance compared with free-hand methods in adolescent idiopathic scoliosis posterior spinal surgery: a systematic review on screw-related complications and breach rates. Spine J 17(9):1215–1229. (PMID: 10.1016/j.spinee.2017.04.00128428081) Chan A et al (2020) Does image guidance decrease pedicle screw-related complications in surgical treatment of adolescent idiopathic scoliosis: a systematic review update and meta-analysis. Eur Spine J 29(4):694–716. (PMID: 10.1007/s00586-019-06219-331781863) Moore HG et al (2021) Use of intraoperative navigation for posterior spinal fusion in adolescent idiopathic scoliosis surgery is safe to consider. Spine Deform 9(2):403–410. (PMID: 10.1007/s43390-020-00218-x33025389) Gelalis ID et al (2012) Accuracy of pedicle screw placement: a systematic review of prospective in vivo studies comparing free hand, fluoroscopy guidance and navigation techniques. Eur Spine J 21(2):247–255. (PMID: 10.1007/s00586-011-2011-321901328) Larson AN et al (2012) The accuracy of navigation and 3D image-guided placement for the placement of pedicle screws in congenital spine deformity. J Pediatr Orthop 32(6):e23–e29. (PMID: 10.1097/BPO.0b013e318263a39e22892631) Rajasekaran S et al (2007) Randomized clinical study to compare the accuracy of navigated and non-navigated thoracic pedicle screws in deformity correction surgeries. Spine (Phila Pa 1976) 32(2):E56-64. (PMID: 10.1097/01.brs.0000252094.64857.ab17224800) Hicks JM et al (2010) Complications of pedicle screw fixation in scoliosis surgery: a systematic review. Spine (Phila Pa 1976) 35(11):E465–E470. (PMID: 10.1097/BRS.0b013e3181d1021a20473117) Ledonio CG et al (2011) Pediatric pedicle screws: comparative effectiveness and safety: a systematic literature review from the Scoliosis Research Society and the Pediatric Orthopaedic Society of North America task force. J Bone Joint Surg Am 93(13):1227–1234. (PMID: 10.2106/JBJS.J.0067821776576) Lonstein JE et al (1999) Complications associated with pedicle screws. J Bone Joint Surg Am 81(11):1519–1528. (PMID: 10.2106/00004623-199911000-0000310565643) Su AW et al (2017) How does patient radiation exposure compare with low-dose O-arm versus fluoroscopy for pedicle screw placement in idiopathic scoliosis? J Pediatr Orthop 37(3):171–177. (PMID: 10.1097/BPO.000000000000060827453221) Borders HL et al (2012) Use of a dedicated pediatric CT imaging service associated with decreased patient radiation dose. J Am Coll Radiol 9(5):340–343. (PMID: 10.1016/j.jacr.2011.12.02722554632) Mathews JD et al (2013) Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ 346:f2360. (PMID: 10.1136/bmj.f2360236946873660619) Su AW et al (2016) Switching to a pediatric dose o-arm protocol in spine surgery significantly reduced patient radiation exposure. J Pediatr Orthop 36(6):621–626. (PMID: 10.1097/BPO.000000000000050426296221) Sklar M et al (2021) First case report using optical topographic-guided navigation in revision spinal fusion for calcified thoracic disk. J Clin Neurosci 91:80–83. (PMID: 10.1016/j.jocn.2021.06.03134373063) Romanyukha A et al (2016) Body size-specific effective dose conversion coefficients for CT scans. Radiat Prot Dosimetry 172(4):428–437. (PMID: 10.1093/rpd/ncv51126755767) Comstock CP, Wait E (2023) Novel machine vision image guidance system significantly reduces procedural time and radiation exposure compared with 2-dimensional fluoroscopy-based guidance in pediatric deformity surgery. J Pediatr Orthop 43(5):e331–e336. (PMID: 10.1097/BPO.00000000000023773688289210082057) Ughwanogho E et al (2012) Computed tomography-guided navigation of thoracic pedicle screws for adolescent idiopathic scoliosis results in more accurate placement and less screw removal. Spine (Phila Pa 1976) 37(8):E473–E478. (PMID: 10.1097/BRS.0b013e318238bbd922020579) Mathew S et al (2021) Defining the learning curve in CT-guided navigated thoracoscopic vertebral body tethering. Spine Deform 9(6):1581–1589. (PMID: 10.1007/s43390-021-00364-w34003460) Larson AN (2022) Innovation with ethics in pediatric orthopaedics. J Pediatr Orthop 42(Suppl 1):S39-s43. (PMID: 10.1097/BPO.000000000000209935405701) Abul-Kasim K et al (2012) Optimization of radiation exposure and image quality of the cone-beam O-arm intraoperative imaging system in spinal surgery. J Spinal Disord Tech 25(1):52–58. (PMID: 10.1097/BSD.0b013e318211fdea21423057) |
فهرسة مساهمة: | Keywords: C-arm; CT-guided navigation; Intraoperative CT; O-arm; Optical navigation system; Preoperative CT; Radiation exposure; Scoliosis; Spinal deformity; Spine surgery |
تواريخ الأحداث: | Date Created: 20231023 Date Completed: 20240215 Latest Revision: 20240415 |
رمز التحديث: | 20240415 |
DOI: | 10.1007/s43390-023-00772-0 |
PMID: | 37870680 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2212-1358 |
---|---|
DOI: | 10.1007/s43390-023-00772-0 |