title: Assessment of the Radiation Exposure of Surgeons and Patients During a Lumbar Microdiskectomy and a Cervical Microdiskectomy: A French Prospective Multicenter Study.
abstract: Cervical and lumbar disk herniations are the most frequently carried out procedures in spinal surgery. Often, a few snapshots during the procedure are necessary to validate the level or to position the implant. The objective of this study is to quantitatively estimate the radiation received by a spine surgeon and patient during a low-dose radiation procedure.
  
  
  
  We conducted a prospective multicenter study in France from November 2014 to April 2015. Four spine centers were monitored for radiation received by surgeons during interventions for lumbar disk herniation and cervical disk herniation.
  
  
  
  A total of 134 patients were included. For lumbar disk herniation, the average exposure for the surgeon was 0.584 μSv on the chest, 5.291 μSv on the lens, and 9.295 μSv on the hands per procedure. For these procedures, the dose area product (DAP) was 94.2 ± 198.4 cGy·cm(2), and the fluoroscopic time was 10.2 ± 16.9 seconds. For a herniated cervical disk, the average exposure for the surgeon was 0.122 μSv on the chest, 3.106 μSv on the lens, and 7.143 μSv on the hands per procedure. For these procedures, the DAP was 35.7 ± 72.1 cGy·cm(2), and the fluoroscopic time was 19.7 ± 13.7 seconds.
  
  
  
  Exposure to x-rays for surgeons and patients during surgery for lumbar disk herniation is higher than during surgery for cervical herniation disk. Our results show that radiation exposure to the spine surgeon is still far below the annual dose limits.
authors.affiliation: Department of Neurosurgery, Dijon University Hospital, Dijon, France. Electronic address: michael.grelat@gmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Grelat
authors.affiliation: Department of Radiology, Nîmes University Hospital, Medical Imaging Group Nîmes, Nîmes Cedex, France.
authors.forename: Joël
authors.initials: J
authors.lastname: Greffier
authors.affiliation: Department of Neurosurgery, Clinique des Cèdres, Cornebarrieu, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Sabatier
authors.affiliation: Department of Spine Surgery, Clinique Ambroise Paré, Neuilly sur Seine, France.
authors.forename: Cyril
authors.initials: C
authors.lastname: Dauzac
authors.affiliation: Department of Orthopaedic Surgery, European Hospital Georges Pompidou, Paris, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Lonjon
authors.affiliation: Department of Neurosurgery, Clinique des Cèdres, Cornebarrieu, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Debono
authors.affiliation: Department of Medical Physics, Montpellier University Hospital, Montpellier Cedex, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Le Roy
authors.affiliation: Department of Orthopedic and Spine Surgery, University Hospital Carémeau, Nîmes, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Kouyoumdjïan
authors.affiliation: Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lonjon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D017586:Diskectomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects; D005602:France; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D016273:Occupational Exposure; D011446:Prospective Studies; D000069079:Radiation Exposure; D011835:Radiation Protection; D011874:Radiometry; D066231:Surgeons; D055815:Young Adult
keywords: Cervical spine; Intraoperative fluoroscopy; Lumbar spine; Radiation exposure; Radiation safety; Spinal surgery; Surgeon