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骨科医生在经皮椎弓根螺钉置入术时不同位置的职业辐射暴露:一项人体模型研究。

Occupational radiation exposure of orthopedists at different locations during pedicle screw insertion: An anthropomorphic phantom study.

机构信息

Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Taiwan.

出版信息

Technol Health Care. 2021;29(S1):211-219. doi: 10.3233/THC-218021.

Abstract

BACKGROUND

The purpose of this work was to evaluate orthopedic surgeons' exposure to occupational radiation doses from scattering using a mobile flat panel C-arm X-ray machine at different standing positions during an intraoperative pedicle screw implantation.

OBJECTIVE

Evaluate the radiation dose received by medical staff, by applying flat X-ray machine in surgical room during an intraoperative pedicle screw implantation.

METHODS

A mobile flat-panel C-arm X-ray machine at a dedicated orthopedic operating room was used to image an anthropomorphic female phantom which was set in a prone position on the operating table. The X-ray was projected horizontally, and 1 minute continuous fluoroscopy was used for lumbar spine and thoracolumbar spine during pedicle screw implantation. Scattering radiation doses to orthopedic surgeons were measured at different standing positions and body heights (50, 100, 150 cm above the ground) with and without limited collimations.

RESULTS

The dose area product (DAP) in this experiment is normalized as 343 μGy⋅m2. In the four areas, the lowest scattered radiation measured by DF is 11.2 vs. 0.7 μSv, outside and inside the lead suit, respectively, with or without restricted field, 150 cm above the ground, and the lowest scattered radiation dose inside the lead suit. It is 1.3 vs. 0.5 μSv. Comparing the highest dose of the TF at with the lowest dose of the DF, the average result is 73.7 vs. 11.1 μSv, P< 0.05.

CONCLUSIONS

Using a mobile flat-panel C-arm X-ray machine during a pedicle screw implantation, the minimum scattering radiation to surgeons was found to be at the terminal DF area based on the analysis of the scattering doses orthopedic surgeons were exposed to.

摘要

背景

本研究旨在评估术中经皮椎弓根螺钉植入时,使用移动平板 C 形臂 X 射线机在不同站位时散射对骨科医生职业辐射剂量的影响。

目的

评估术中经皮椎弓根螺钉植入时,在手术室内使用平板 X 射线机对医护人员的辐射剂量。

方法

在专门的骨科手术室,使用移动平板 C 形臂 X 射线机对俯卧位放置在手术台上的女性人体模型进行成像。X 射线水平投射,在腰椎和胸腰椎经皮椎弓根螺钉植入过程中,连续透视 1 分钟。在不同站位和身高(距地面 50、100、150cm),以及有无限制准直器的情况下,测量骨科医生的散射辐射剂量。

结果

本实验中剂量面积乘积(DAP)归一化为 343μGy·m2。在四个区域中,DF 测量的最低散射辐射分别为 11.2 比 0.7μSv,分别为外穿和内穿铅服,有无限制视野,150cm 高,内穿铅服的最低散射辐射剂量为 1.3 比 0.5μSv。TF 最高剂量与 DF 最低剂量相比,平均结果为 73.7 比 11.1μSv,P<0.05。

结论

在经皮椎弓根螺钉植入术中使用移动平板 C 形臂 X 射线机,根据分析骨科医生所受散射剂量,发现最低散射辐射来自终端 DF 区域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1d0/8150624/aac634eee12c/thc-29-thc218021-g001.jpg

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