C-Arm Fluoroscopy, Portable X-ray or CT: 5 Findings on Radiation Exposure During Spine Surgery

The researchers measured radiation exposure from each system. Here are five findings from the study:

1. For single lateral/posterior-anterior entrance, patient radiation exposure was on average:

•    116 mR/102 mR for the C-arm
•    3,435 mR/2,160 mR for the X-ray radiography
•    4,360 mR/5,2220 mR for the O-arm

A study recently published in Spine find examining the radiation exposure to surgeons during pedicle screw placement found that the freehand technique has higher radiation exposure than when surgeons use navigation. Radiation exposure with the freehand technique was reported as 9.96 times greater than when using navigation.

2. Surface exposure for lateral/posterior-anterior approaches for the O-arm was equivalent to 38/41 C-arm exposures and 1.5/2.4 X-ray radiography exposures. The overall radiation exposure to the operating room staff was less than 4.4 for a single acquisition of all modalities.

3. The surgeon and surgeon assistant had higher levels of scatter radiation for C-arm, followed by O-arm and then X-ray radiography. "Assessment of radiation risk to the patient and OR staff should be part of the decision for utilization of any specific imaging modality during spinal surgery," concluded the study authors.

4. In the lateral C-arm acquisition, there was a 7.7-fold increase in radiation exposure was measured on the X-ray tube side compared to the detector side.

5. The anesthesiologist scatter radiation level for a single acquisition was highest for the O-arm. The second highest was the X-ray radiology, followed by the C-arm. For radiologic technologists, scatter radiation level was highest for X-ray, followed by the O-arm and then fluoroscopy.

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