Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC, University of Amsterdam and Vrije Universiteit, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Amsterdam Movement Sciences, Amsterdam, The Netherlands.
Eur Spine J. 2023 May;32(5):1777-1786. doi: 10.1007/s00586-023-07651-2. Epub 2023 Mar 21.
Adolescent idiopoathic scoliosis (AIS) is a progressive spinal deformity, most often observed in female patients of pubescent age. The deformity's severity, its progression through time, its treatment and subsequent follow-up are assessed with routine radiological evaluation of the patient's full spine. This study aimed to determine the cumulative radiation exposure in average patients with AIS treated by brace or surgery throughout their treatment.
The average number of imaging procedures and corresponding radiation doses were retrospectively obtained from the medical charts of AIS patients treated conservatively and/or surgically at our institution. The median radiation exposure of all imaging modalities was stated in effective dose (mSv). The estimated cumulative effective radiation dose of the each treatment group was determined by multiplication of the average number of imaging conducted, and the median effective radiation dose per imaging modality.
In total, 73 AIS patients were included (28 brace, 45 surgically). Patients treated with a brace were subjected to an average of 9.03 full spine radiographs, resulting in an estimated effective cumulative dose of 0.505 mSv over a median treatment period of 3.23 years. Patients treated surgically received an average of 14.29 full spine radiographs over a median treatment period of 2.76 years. The estimated effective cumulative dose amounted from 0.951 to 1.841 mSv, depending on the surgical technique.
The cumulative effective radiation doses rendered to AIS patients as part of their treatment and follow-up were relatively low. However, every exposure to ionising radiation for medical imaging purposes should be minimised.
青少年特发性脊柱侧凸（AIS）是一种进行性脊柱畸形，最常发生在青春期女性患者中。该畸形的严重程度、随时间的进展、治疗和随后的随访都是通过对患者整个脊柱的常规放射学评估来评估的。本研究旨在确定通过支具或手术治疗的 AIS 平均患者在整个治疗过程中的累积辐射暴露量。
从我院保守治疗和/或手术治疗的 AIS 患者的病历中回顾性获得平均影像学检查次数和相应的辐射剂量。所有影像学检查的平均辐射剂量以有效剂量（mSv）表示。通过将每个治疗组进行的平均影像学检查次数与每个影像学检查的中位数有效辐射剂量相乘，确定每个治疗组的累积有效辐射剂量。
共有 73 例 AIS 患者入组（28 例支具治疗，45 例手术治疗）。接受支具治疗的患者平均接受 9.03 次全脊柱 X 线检查，在中位数为 3.23 年的治疗期间，估计有效累积剂量为 0.505 mSv。接受手术治疗的患者在中位数为 2.76 年的治疗期间平均接受 14.29 次全脊柱 X 线检查。估计有效累积剂量在 0.951 至 1.841 mSv 之间，具体取决于手术技术。
作为 AIS 患者治疗和随访的一部分，累积有效辐射剂量相对较低。然而，应尽量减少因医学影像学目的而接触电离辐射。
