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经椎间孔腰椎内镜脊柱手术期间患者的辐射暴露:一项前瞻性研究。

Patient radiation exposure during transforaminal lumbar endoscopic spine surgery: a prospective study.

作者信息

Iprenburg Menno, Wagner Ralf, Godschalx Alexander, Telfeian Albert E

机构信息

Spine Clinic Iprenburg, Veenhuizen, The Netherlands;

Ligamenta Spine Centre, Frankfurt am Main, Germany; and.

出版信息

Neurosurg Focus. 2016 Feb;40(2):E7. doi: 10.3171/2015.11.FOCUS15485.

Abstract

OBJECTIVE The aim of this study was to describe patient radiation exposure during single-level transforaminal endoscopic lumbar discectomy procedures at levels L2-5 and L5-S1. METHODS Radiation exposure was monitored in 151 consecutive patients undergoing single-level transforaminal endoscopic lumbar discectomy procedures. Two groups were studied: patients undergoing procedures at the L4-5 level or above and those undergoing an L5-S1 procedure. RESULTS For the discectomy procedures at L4-5 and above, the average duration of fluoroscopy was 38.4 seconds and the mean calculated patient radiation exposure dose was 1.5 mSv. For the L5-S1 procedures, average fluoroscopy time was 54.6 seconds and the mean calculated radiation exposure dose was 2.1 mSv. The average patient radiation exposure dose among these cases represents a 3.5-fold decrease compared with the senior surgeon's first 100 cases. CONCLUSIONS Transforaminal lumbar endoscopic discectomy can be used as a minimally invasive technique for the treatment of lumbar radiculopathy in the setting of a herniated lumbar disc without the significant concern of exposing the patient to harmful doses of radiation. One caveat is that both the surgeon and the patient are likely to be exposed to higher doses of radiation during a surgeon's early experience in minimally invasive endoscopic spine surgery.

摘要

目的 本研究旨在描述L2 - 5和L5 - S1节段单节段经椎间孔内镜下腰椎间盘切除术患者的辐射暴露情况。方法 对151例连续接受单节段经椎间孔内镜下腰椎间盘切除术的患者进行辐射暴露监测。研究分为两组:L4 - 5及以上节段手术患者和L5 - S1节段手术患者。结果 对于L4 - 5及以上节段的椎间盘切除术,透视平均时长为38.4秒,计算得出的患者平均辐射暴露剂量为1.5 mSv。对于L5 - S1节段手术,透视平均时间为54.6秒,计算得出的平均辐射暴露剂量为2.1 mSv。这些病例中的患者平均辐射暴露剂量与资深外科医生的前100例病例相比降低了3.5倍。结论 经椎间孔腰椎内镜下椎间盘切除术可作为一种微创技术用于治疗腰椎间盘突出症所致的腰椎神经根病,无需担心患者受到有害剂量的辐射。一个需要注意的是,在外科医生早期的微创内镜脊柱手术经验中,外科医生和患者都可能受到更高剂量的辐射。

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