Lebhar J, Bryand C, Breton Y, Bourgouin A, Chatellier P, Ropars M. Can intraoperative radiation dose in percutaneous posterior thoracolumbar internal fixation be reduced by impedancemetry-guided pedicle sighting? A prospective randomized study.
Orthop Traumatol Surg Res 2023;
109:103250. [PMID:
35181515 DOI:
10.1016/j.otsr.2022.103250]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/24/2021] [Accepted: 06/18/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION
Percutaneous spine surgery is on the rise; the main drawback is iterative irradiation of the care team in theater. The aim of the present study was to compare intraoperative radiation dose in percutaneous posterior thoracolumbar internal fixation (PPTLIF) using impedancemetry-guided pedicle sighting by the PediGuard device (SpineGuard®) versus gold-standard free-hand sighting.
MATERIAL AND METHODS
A single-center, single-surgeon continuous prospective randomized study was conducted from September 2017 to April 2018. Dose-area product (DAP, in cGy.cm2) was recorded at the end of pedicle sighting and end of surgery in the free-hand control group and the impedancemetry group. Pedicle screw position was studied on postoperative CT scan.
RESULTS
Sixteen patients were included in either group after 2 had been excluded. The groups were comparable for age, gender, body-mass index (BMI), indication and number of instrumented levels. Mean DPA at end of sighting and end of procedure was respectively 147.4 cGy.cm2 and 230.9 cGy.cm2 in the control group and 171.1 cGy.cm2 and 280.7 cGy.cm2 in the PediGuard group (p> 0.05). Screw positioning on CT was comparable in the 2 groups.
CONCLUSION
In the present study, the PediGuard device did not reduce intraoperative radiation dose. The correlation between radiation dose and BMI was confirmed.
LEVEL OF EVIDENCE
II; prospective randomized study.
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