Revolutionizing Spine Surgery: Minimizing Radiation Risks with Precision Navigation

Welcome to latest edition of our June newsletter!

This month, we're focusing on a crucial aspect of spine surgery: minimizing radiation exposure for both patients and medical professionals. In this issue, we'll explore the evolution of surgical techniques and the groundbreaking advancements that are making spine surgery safer and more effective.

The Risks of Fluoroscopy and the Rise of New Techniques

Reducing radiation in spine surgery is crucial for enhancing the safety of everyone involved. Historically, surgeons relied on X-ray imaging (fluoroscopy) during spine surgeries, which poses significant risks due to excessive radiation exposure. To address this issue, new methods now incorporate advanced technologies such as CT or MRI scans, along with computer-guided tools. These innovations assist surgeons in precise preoperative planning and provide real-time guidance during procedures, increasing safety and reducing the need for continuous X-ray imaging.

Why Reducing Radiation Matters: Safety for Everyone

The primary goal of these advancements is to improve surgical outcomes while minimizing radiation exposure risks. Continuous research and innovations in this field strive to refine these techniques, making spine surgeries safer and more effective. Spine surgeries often involve significant radiation, raising concerns about potential long-term effects on both the environment and individuals. Performing numerous surgeries over the years may contribute to increased radiation exposure, which can have cumulative effects on the surrounding environment and the health of medical professionals and patients.

The Problem: Traditional Techniques and High Radiation Exposure

The widespread adoption of navigation systems in spine surgery was driven by the significant radiation exposure to both patients and surgeons using traditional pre-navigation techniques. For instance, Theocharopoulos et al. found that a spine surgeon's radiation exposure was 50 times that of a hip surgeon, underscoring the critical need to limit radiation exposure. This elevated risk highlights the urgency of implementing advanced navigation systems in spine surgery to protect medical professionals and patients alike.

A Major Benefit of CAN: Protecting Surgeons from Radiation

One of the primary benefits of Computer-Assisted Navigation (CAN) is its ability to significantly reduce radiation exposure to surgeons. In an initial study by Kim et al., the role of navigation in minimizing radiation exposure was evaluated, demonstrating a substantial reduction in fluoroscopy time by 90 seconds per case. Moreover, the study showed that navigation systems completely negated radiation exposure to surgeons, allowing them to leave the room during fluoroscopy. This finding emphasizes the dual benefits of navigation: enhancing surgical precision and prioritizing the safety of the surgical team.

FB CT-Based Systems: Lowering Patient Radiation

Furthermore, the FB CT-based system has shown promising results in reducing intraoperative radiation exposure to patients. Tu et al. reported that this system not only shortened the time required for screw placement but also significantly reduced radiation exposure during Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS-TLIF) procedures. These improvements highlight the potential benefits of adopting novel navigation systems to enhance surgical precision and mitigate radiation-related risks.

Spine Surgery's Future: Less Radiation, Better Outcomes

Incorporating advanced navigation technologies in spine surgery is crucial for reducing radiation exposure and improving surgical outcomes. As research and innovations continue to evolve, these developments will play a vital role in ensuring the safety of both patients and medical professionals. By embracing these advanced technologies, the field of spine surgery can move towards a future where the risks associated with radiation exposure are significantly minimized, leading to better health outcomes and safer surgical practices.

References:

• Theocharopoulos, N., Perisinakis, K., Damilakis, J., et al. (2003). Occupational exposure from common fluoroscopic projections used in orthopaedic surgery. Journal of Bone and Joint Surgery American, 85(9), 1698-1703. doi: 10.2106/00004623-200309000-00007
• Kim, C. W. (2008). Use of navigation-assisted fluoroscopy to decrease radiation exposure during minimally invasive spine surgery. Spine Journal, 8(6), 584-590. doi: 10.1016/j.spinee.2006.12.012
• Tu, T.-H., Kuo, Y.-H., Chang, C.-C., Kuo, C.-H., Chang, H.-K., Fay, L.-Y., Yeh, M.-Y., Ko, C.-C., Huang, W.-C., & Wu, J.-C. (2023). Comparison of intraoperative cone-beam CT versus preoperative fan-beam CT for navigated spine surgery: a prospective randomized study. Spine, 48(19), E882-E889. doi: 10.3171/2023.9.SPINE23422

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