Safety and accuracy of spinal instrumentation surgery in a hybrid operating room with an intraoperative cone-beam computed tomography.
Adult
Aged
Aged, 80 and over
Bone Screws
Computed Tomography Angiography
/ instrumentation
Cone-Beam Computed Tomography
/ adverse effects
Female
Humans
Intraoperative Care
Male
Middle Aged
Operating Rooms
/ classification
Radiation Exposure
Retrospective Studies
Spinal Diseases
/ surgery
Spinal Fusion
/ adverse effects
Spine
/ surgery
Treatment Outcome
Young Adult
Cone-beam CT
Hybrid operating room
Radiation exposure
Spinal instrumentation
Surgical safety
Journal
Neurosurgical review
ISSN: 1437-2320
Titre abrégé: Neurosurg Rev
Pays: Germany
ID NLM: 7908181
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
05
02
2018
accepted:
28
03
2018
revised:
20
03
2018
pubmed:
18
4
2018
medline:
4
9
2019
entrez:
18
4
2018
Statut:
ppublish
Résumé
Although spinal instrumentation technique has undergone revolutionary progress over the past few decades, it may still carry significant surgery-related risks. The purpose of the present study was to assess the radiological accuracy of spinal screw instrumentation using a hybrid operating room (OR) and quantify the related radiation exposure. This retrospective study included 33 cases of complex spine fusion surgeries that were conducted using a hybrid OR with a flat panel detector (FPD) angiography system. Twelve cases (36.4%) were cervical, and 21 (63.6%) were thoracolumbar. The average number of spine fusion levels was 3 and 4.8, respectively, at the cervical and thoracolumbar spine levels. A FPD angiography system was used for intraoperative cone-beam computed tomography (CBCT) to obtain multi-slice spine images. All operations were conducted under optimized radiation shielding. Entrance surface doses (ESDs) and exposure times were recorded in all cases. A total of 313 screws were placed. Satisfactory screw insertion could be achieved in all cases with safe screw placement in 97.4% and acceptable placement in 2.6%. None of the cases showed any significant anatomical violation by the screws. The radiation exposure to the patients was absolutely consistent with the desired ESD value, and that to the surgeons, under the annual dose limit. These results suggest that the hybrid OR with a FPD angiography system is helpful to achieve safe and precise spinal fusion surgery, especially in complex cases.
Identifiants
pubmed: 29663092
doi: 10.1007/s10143-018-0977-6
pii: 10.1007/s10143-018-0977-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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