title: Radiation Exposure to the Hand of a Spinal Interventionalist during Fluoroscopically Guided Procedures.
abstract: METHODS
  Prospective study.
  
  
  OBJECTIVE
  During fluoroscopically guided spinal procedure, the hands of spinal surgeons are placed close to the field of radiation and may be exposed to ionizing radiation. This study directly measured the radiation exposure to the hand of a spinal interventionalist during fluoroscopically guided procedures.
  
  
  BACKGROUND
  Fluoroscopically guided spinal procedures have been reported to be a cause for concern due to the radiation exposure to which their operators are exposed.
  
  
  METHODS
  This prospective study evaluated the radiation exposure of the hand of one spinal interventionalist during 52 consecutive fluoroscopic spinal procedures over a 3-month period. The interventionalist wore three real-time dosimeters secured to the right forearm, under the lead apron over the chest, and outside the lead apron over the chest. Additionally, one radiophotoluminescence glass dosimeter was placed under the lead apron over the left chest and one ring radiophotoluminescence glass dosimeter was worn on the right thumb. The duration of exposure and radiation dose were measured for each procedure.
  
  
  RESULTS
  The average radiation exposure dose per procedure was 14.9 µSv, 125.6 µSv, and 200.1 µSv, inside the lead apron over the chest, outside the lead apron over the chest, and on the right forearm, respectively. Over the 3-month period, the protected radiophotoluminescence glass dosimeter over the left chest recorded less than the minimum reportable dose, whereas the radiophotoluminescence glass ring dosimeter recorded 368 mSv for the thumb.
  
  
  CONCLUSIONS
  Our findings indicated that the cumulative radiation dose measured at the dominant hand may exceed the annual dose limit specified by the International Commission on Radiological Protection. Spinal interventionalists should take special care to limit the duration of fluoroscopy and radiation exposure.
authors.affiliation: Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
authors.forename: Kazuta
authors.initials: K
authors.lastname: Yamashita
authors.affiliation: Department of Orthopedics, Kagawa Rosai Hospital, Marugame, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Ikuma
authors.affiliation: Department of Orthopedics, Kagawa Rosai Hospital, Marugame, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Tokashiki
authors.affiliation: Department of Orthopedics, Kagawa Rosai Hospital, Marugame, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Maehara
authors.affiliation: Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nagamachi
authors.affiliation: Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Takata
authors.affiliation: Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
authors.forename: Toshinori
authors.initials: T
authors.lastname: Sakai
authors.affiliation: Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
authors.forename: Kosaku
authors.initials: K
authors.lastname: Higashino
authors.affiliation: Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Sairyo
keywords: Fingers; Fluoroscopy; Hand; Radiation exposure; Spinal procedure