title: Diagnostic radiation exposure in children with spinal dysraphism: an estimation of the cumulative effective dose in a cohort of 135 children from The Netherlands.
abstract: OBJECTIVE
  Based on the assumption that children with spinal dysraphism are exposed to a large amount of ionising radiation for diagnostic purposes, our objective was to estimate this exposure, expressed in cumulative effective dose.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  The Netherlands.
  
  
  METHODS
  135 patients with spinal dysraphism and under 18 years of age treated at our institution between 1991 and 2010.
  
  
  RESULTS
  A total of 5874 radiological procedures were assessed of which 2916 (49.6%) involved ionising radiation. Mean cumulative effective dose of a child with spinal dysraphism during childhood was 23 mSv, while the individual cumulative effective dose ranged from 0.1 to 103 mSv. Although direct radiography accounted for 81.7% of examinations, the largest contributors to the cumulative effective dose were fluoroscopic examinations (40.4% of total cumulative effective dose).
  
  
  CONCLUSIONS
  Exposure to ionising radiation and associated cancer risk were lower than expected. Nevertheless, the use of ionising radiation should always be justified and the medical benefits should outweigh the risk of health detriment, especially in children.
authors.affiliation: Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, The Netherlands. j.van.aalst@mumc.nl
authors.forename: Jasper
authors.initials: J
authors.lastname: van Aalst
authors.forename: Cécile R L P N
authors.initials: CR
authors.lastname: Jeukens
authors.forename: Johan S H
authors.initials: JS
authors.lastname: Vles
authors.forename: Emiel A
authors.initials: EA
authors.lastname: van Maren
authors.forename: Alfons G H
authors.initials: AG
authors.lastname: Kessels
authors.forename: Dan L H M
authors.initials: DL
authors.lastname: Soudant
authors.forename: Jacobiene W
authors.initials: JW
authors.lastname: Weber
authors.forename: Alida A
authors.initials: AA
authors.lastname: Postma
authors.forename: Erwin M J
authors.initials: EM
authors.lastname: Cornips
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology*; D009426:Netherlands; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D016135:Spinal Dysraphism / Q000000981:diagnostic imaging*
keywords: Imaging; Multidisciplinary team-care; Neurology; Neurosurgery; Oncology