Wojdyn Maciej, Pierzak Olaf, Zapałowicz Krzysztof, Radek Maciej
Department of Neurosurgery, Surgery of Spine and Peripheral Nerves, Medical University of Lodz, University Hospital WAM-CSW, Lodz, Poland.
Department of Neurosurgery, Prof. Gibiński Central Clinical Hospital, Katowice, Poland.
Arch Med Sci. 2019 Apr 8;17(1):113-119. doi: 10.5114/aoms.2019.84269. eCollection 2021.
Percutaneous vertebroplasty is commonly used to treat spinal fractures. The authors compare radiation exposure as potential risk for the surgical team during vertebroplasty guided by O-arm combined with neuronavigation versus vertebroplasty guided by C-arm fluoroscopy.
The clinical material consisted of a group of 29 patients (44 vertebrae) with fractures of the thoracolumbar spine treated with percutaneous vertebroplasty guided by O-arm with neuronavigation. In this new method, the operating room staff leaves the operating room for the duration of the 3D scan of the appropriate spine section using the O-arm. In the next stage, the needle of the vertebroplasty system is introduced using only neuronavigation without the need for a radiological view. Finally, the cement injection was made under O-arm fluoroscopic control. The comparison group consisted of a group of 35 patients (40 vertebrae) treated with the classical method using C-arm fluoroscopy. The two methods were compared in terms of the average dose of emitted ionizing radiation through the device (O-arm vs. C-arm) to which surgeons are exposed during percutaneous vertebroplasty.
As a result of vertebroplasty procedures guided by neuronavigation, a statistically significant difference between the values of mean dose of radiation emitted by O-arm and C-arm systems was noted. The O-arm emitted 912 cGy/cm vs. 1722 cGy/cm emitted by the C-arm during fluoroscopically assisted procedures and 601.28 cGy/cm vs. 1506.86 cGy/cm per vertebrae.
During vertebroplasty with the O-arm combined with neuronavigation the radiation dose is significantly lower as compared with the C-arm used for fluoroscopic guidance, minimizing the potential risk of radiation exposure to surgeons.
经皮椎体成形术常用于治疗脊柱骨折。作者比较了在O型臂联合神经导航引导下进行椎体成形术与C型臂荧光透视引导下进行椎体成形术时，手术团队所面临的辐射暴露这一潜在风险。
临床资料包括一组29例（44个椎体）胸腰椎骨折患者，采用O型臂联合神经导航引导下的经皮椎体成形术进行治疗。在这种新方法中，手术室工作人员在使用O型臂对相应脊柱节段进行三维扫描期间离开手术室。在下一阶段，仅使用神经导航引入椎体成形术系统的针，无需放射学视野。最后，在O型臂荧光透视控制下进行骨水泥注射。对照组包括一组35例（40个椎体）采用传统C型臂荧光透视法治疗的患者。比较了两种方法在经皮椎体成形术期间外科医生通过设备（O型臂与C型臂）所接受的平均电离辐射剂量。
在神经导航引导的椎体成形术过程中，注意到O型臂和C型臂系统发出的平均辐射剂量值之间存在统计学上的显著差异。在荧光透视辅助手术期间，O型臂发出912 cGy/cm，而C型臂发出1722 cGy/cm；每个椎体分别为601.28 cGy/cm和1506.86 cGy/cm。
与用于荧光透视引导的C型臂相比，在O型臂联合神经导航的椎体成形术中，辐射剂量显著降低，将外科医生辐射暴露的潜在风险降至最低。
