Fan Guoxin, Fu Qingsong, Gu Guangfei, Zhang Hailong, Guan Xiaofei, Zhang Lei, Gu Xin, He Shisheng
*Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai †Department of Orthopaedics, Ningbo No. 2 Hospital, Ningbo, China.
J Spinal Disord Tech. 2015 Apr;28(3):E173-80. doi: 10.1097/BSD.0000000000000210.
A prospective study.
To further investigate the implication of our surface locator and intradermal locator to reduce the radiation exposure to surgeons in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) surgery.
Our previous studies published in the journal have introduced our novel spinal locators effectively minimizing fluoroscopic time during minimally invasive spinal surgery.
Twenty patients underwent MIS-TLIF surgery with G-arm fluoroscopy from January 2013 to June 2013. There were 10 patients in group A who underwent standard MIS-TLIF using our spinal locators, and the other 10 in group B underwent conventional MIS-TLIF without spinal locators. The radiation dosages to the arm, the finger, the whole body, thyroid gland, gonad gland, and the eye of the surgeon were measured by thermoluminescence badges for both groups.
All 20 patients (9 male, 11 female), aged from 48 to 77 years old, successfully underwent the surgery. The operation time was 171.20±10.28 minutes for group A and 189.80±11.99 minutes for group B. The fluoroscopy time was 49.60±7.32 seconds for group A and 68.40±7.62 seconds for group B, hence a reduction of 27.49% was observed. There was no correlation between operation time and exposure time for group A or group B. The radiation reduction was 35.28% for the arm, 17.95% for the finger, 45.23% for the whole body, 53.62% for the thyroid gland (protected), 52.44% for the thyroid gland (unprotected), 44% for gonad gland (protected), 36.42% for the gonad gland (unprotected), 59.42% for the eye (protected), and 59.70% for the eye (unprotected).
The study indicated that radiation exposure to the surgeon would be effectively reduced in MIS-TLIF using our surface locator and intradermal locator, and it could be another practical choice for radiation-minimizing strategy.
一项前瞻性研究。
进一步探究我们的体表定位器和皮内定位器在微创经椎间孔腰椎椎间融合术（MIS-TLIF）中减少外科医生辐射暴露方面的作用。
我们此前发表在该杂志上的研究介绍了我们的新型脊柱定位器，其能在微创脊柱手术中有效减少透视时间。
2013年1月至2013年6月，20例患者接受了使用G型臂透视的MIS-TLIF手术。A组10例患者使用我们的脊柱定位器进行标准MIS-TLIF手术，B组另外10例患者进行不使用脊柱定位器的传统MIS-TLIF手术。两组均通过热释光剂量计测量外科医生手臂、手指、全身、甲状腺、性腺和眼睛的辐射剂量。
所有20例患者（9例男性，11例女性），年龄48至77岁，均成功完成手术。A组手术时间为171.20±10.28分钟，B组为189.80±11.99分钟。A组透视时间为49.60±7.32秒，B组为68.40±7.62秒，减少了27.49%。A组或B组的手术时间与暴露时间之间均无相关性。手臂辐射减少35.28%，手指减少17.95%，全身减少45.23%，甲状腺（受保护）减少53.62%，甲状腺（未受保护）减少52.44%，性腺（受保护）减少44%，性腺（未受保护）减少36.42%，眼睛（受保护）减少59.42%，眼睛（未受保护）减少59.70%。
该研究表明，在MIS-TLIF手术中使用我们的体表定位器和皮内定位器可有效减少外科医生的辐射暴露，这可能是辐射最小化策略的另一个实用选择。
