Radiation exposure comparison using three fluoroscopic techniques on percutaneous transpedicular procedures

Abstract Background The lack of anatomical landmarks during percutaneous access to vertebral pedicle may increase the need for intraoperative fluoroscopy, which results in additional radiation exposure for surgeon, patient and radiation technician. The goal of the study was to compare the radiation exposure to surgeon, patient and radiation technician during percutaneous access of the vertebral pedicle using three different fluoroscopic imaging set up. Methods Percutaneous access in T9-L5 pedicle of nine adult male cadavers using three different fluoroscopic set up: standard C-arm, C-arm with L-arm and biplanar technique was performed. Radiation dose exposure of surgeon, radiation technician and cadaver was measured using dosimeters. The measurement was taken by a radiation dosimeter in real time per procedure. Results The radiation dose absorbed by surgeon was higher when using standard C-arm fluoroscopic technique than using C-arm with L-arm or biplanar technique. Conclusion The use of C-arm with L-arm or biplanar fluoroscopic technique for percutaneous access of vertebral pedicle reduces the radiation exposure of the surgeon compared to the standard C-arm fluoroscopic technique.