Radiation Exposure During Lumbar Interbody Fusion Surgery Can Be Reduced by Using a Three-Dimensional Patient-Specific Template Guide.

Autor:	Nagashima Y; Orthopedic Surgery, Sanmu Medical Center, Sanmu, JPN., Ishikawa T; Orthopedic Surgery, Sanmu Medical Center, Sanmu, JPN., Katsuragi J; Orthopedic Surgery, Sanmu Medical Center, Sanmu, JPN., Sasaki Y; Orthopedic Surgery, Sanmu Medical Center, Sanmu, JPN., Suzuki M; Orthopedic Surgery, Sanmu Medical Center, Sanmu, JPN., Umimura T; Orthopedic Surgery, Sanmu Medical Center, Sanmu, JPN., Sawada R; Orthopedic Surgery, Sanmu Medical Center, Sanmu, JPN., Hashiba D; Orthopedic Surgery, Sanmu Medical Center, Sanmu, JPN., Yamamoto M; Radiology, Sanmu Medical Center, Sanmu, JPN., Ohtori S; Orthopedic Surgery, Chiba University Hospital, Chiba, JPN.; Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, JPN.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Apr 22; Vol. 16 (4), pp. e58787. Date of Electronic Publication: 2024 Apr 22 (Print Publication: 2024).
DOI:	10.7759/cureus.58787
Abstrakt:	Background: The use of posterior lumber interbody fusion (PLIF) using cortical bone trajectory (CBT) with a patient-specific 3D template guide is increasingly widespread. To our knowledge, no studies have extensively evaluated the reduction of radiation exposure when using patient-specific drill template guides. The purpose of this study is to compare the intra-operative radiation dose and surgeon's exposure to radiation in CBT-PLIF when using a patient-specific drill guide with that in traditional minimally invasive (MIS)-PLIF. Methods: In this observational study, we retrospectively compared data from five patients who were treated with single-level CBT-PLIF using a patient-specific drill guide (G group) and five patients who were treated with single-level traditional MIS-PLIF (M group). We compared the surgical time, surgeon's exposure to radiation, and intra-operative radiation time and dose between the two groups of patients. Results: The mean age of the patients was 67.0 years in the M group and 74.2 years in the G group. The average surgical time was 242.8 min in the M group and 189.6 min in the G group (p = 0.020). The surgeon's exposure to radiation was 373.7 µSv in the M group and 81.75 µSv in the G group at chest level outside the protector (p = 0.00092); 42.0 µSv (M group) and 3.6 µSv (G group) at chest level inside the protector (p = 0.0000062); and 4.33 µSv (M group) and 1.20 µSv (G group) at the buttocks of the surgeon (p = 0.0013). Radiation time was 269.8 s (M group) and 56.6 s (G group) (p = 0.0097), and radiation dose was 153.7 mGy (M group) and 30.42 mGy (G group) (p = 0.00057). Conclusion: The patient-specific drill template guide is an invaluable tool that facilitates the safe insertion of CBT screws with a low radiation dose from the outset. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2024, Nagashima et al.)
Databáze:	MEDLINE
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