Jenkins Nathaniel W, Parrish James M, Sheha Evan D, Singh Kern
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
Ann Transl Med. 2021 Jan;9(1):84. doi: 10.21037/atm-20-1052.
Intraoperative radiological imaging serves an essential role in many spine surgery procedures. It is critical that patients, staff and physicians have an adequate understanding of the risks and benefits associated with radiation exposure for all involved. In this review, we briefly introduce the current trends associated with intraoperative radiological imaging. With the increased utilization of minimally invasive spine surgery (MIS) techniques, the benefits of intraoperative imaging have become even more important. Less surgical exposure, however, often equates to an increased requirement for intraoperative imaging. Understanding the conventions for radiation measurement, radiological fundamental concepts, along with deterministic or stochastic effects gives a framework for conceptualizing how radiation exposure relates to the risk of various sequela. Additionally, we describe the various options surgeons have for intraoperative imaging modalities including those based on conventional fluoroscopy, computer tomography, and magnetic resonance imaging. We also describe different ways to prevent unnecessary radiation exposure including dose reduction, better education, and use of personal protective equipment (PPE). Finally, we conclude with a reflection on the progress that has been made to limit intraoperative radiation exposure and the promise of future technology and policy.
术中放射成像在许多脊柱手术中起着至关重要的作用。患者、工作人员和医生充分了解所有相关人员辐射暴露的风险和益处至关重要。在本综述中，我们简要介绍与术中放射成像相关的当前趋势。随着微创脊柱手术（MIS）技术的使用增加，术中成像的益处变得更加重要。然而，手术暴露减少通常等同于术中成像需求增加。了解辐射测量的惯例、放射学基本概念以及确定性或随机性效应，为理解辐射暴露与各种后遗症风险之间的关系提供了一个框架。此外，我们描述了外科医生可用于术中成像模式的各种选择，包括基于传统荧光透视、计算机断层扫描和磁共振成像的模式。我们还描述了防止不必要辐射暴露的不同方法，包括剂量减少、更好的教育以及个人防护设备（PPE）的使用。最后，我们对在限制术中辐射暴露方面取得的进展以及未来技术和政策的前景进行了思考。
