PDF(Pubmed)
Abstract：
BACKGROUND: Three-dimensional (3D) navigation has become routinely used in spine surgery, allowing more accurate and safe procedures. However, radiation exposure related to the use of imaging is an unresolved issue, and information about it is relatively scarce. The \"as low as reasonably achievable\" (ALARA) principle aims to reduce the radiation exposure for the patients as low as possible. The objective of this study was to compare the effective dose related to the use of the O-arm in standard settings with adapted features for dose reduction during percutaneous cementoplasty.
METHODS: From March 2021 to October 2022, all consecutive patients who underwent navigated percutaneous cementoplasty with the use of the O-arm were prospectively included. Demographic, operative, irradiation, and radiological data were collected. The main outcome was the effective dose (E) in millisievert (mSv). Secondary outcomes were the absolute risk of cancer (AR) in percent equivalent to a whole-body exposition, operative time, and radiological results according to Garnier. In group A, patients were operated on with standard settings of the O-arm, whereas in group B, navigation on the field of view, collimation, and low-dose settings were used.
RESULTS: A total of 70 patients were included in the study: 43 in group A and 27 in group B. Also, 109 vertebrae were operated: 59 in group A and 50 in group B. Mean E was significantly higher in group A than in group B (9.94 and 4.34 mSv, respectively; P < 0.01). The 3D-related E followed the same trend (7.82 and 3.97 mSv, respectively), as did 2-dimensional-related E (2.12 and 0.37 mSv, respectively; P < 0.01). Average AR was also significantly higher in group A than in group B (5.10-4% and 2.10-4% respectively; P < 0.01). Operative time was similar in both groups, but the rate of satisfactory radiological results was higher in group A than in group B (95% and 84%, respectively; P = 0.11), and we found similar rates of cement leakage (22% and 24%, respectively; P = 0.71).
CONCLUSIONS: The application of settings of the O-arm in accordance with the ALARA principle helped to significantly reduce the radiation exposure and should be routinely used for O-arm-assisted cementoplasty procedures.
CONCLUSIONS: This study details technical aspects and settings that may help users of the O-arm to decrease radiation exposure to patients and surgeons alike, especially in cementoplasty procedures, as well as in other procedures performed under O-arm guidance.
METHODS:
METHODS: From March 2021 to October 2022, all consecutive patients who underwent navigated percutaneous cementoplasty with the use of the O-arm were prospectively included. Demographic, operative, irradiation, and radiological data were collected. The main outcome was the effective dose (E) in millisievert (mSv). Secondary outcomes were the absolute risk of cancer (AR) in percent equivalent to a whole-body exposition, operative time, and radiological results according to Garnier. In group A, patients were operated on with standard settings of the O-arm, whereas in group B, navigation on the field of view, collimation, and low-dose settings were used.
RESULTS: A total of 70 patients were included in the study: 43 in group A and 27 in group B. Also, 109 vertebrae were operated: 59 in group A and 50 in group B. Mean E was significantly higher in group A than in group B (9.94 and 4.34 mSv, respectively; P < 0.01). The 3D-related E followed the same trend (7.82 and 3.97 mSv, respectively), as did 2-dimensional-related E (2.12 and 0.37 mSv, respectively; P < 0.01). Average AR was also significantly higher in group A than in group B (5.10-4% and 2.10-4% respectively; P < 0.01). Operative time was similar in both groups, but the rate of satisfactory radiological results was higher in group A than in group B (95% and 84%, respectively; P = 0.11), and we found similar rates of cement leakage (22% and 24%, respectively; P = 0.71).
CONCLUSIONS: The application of settings of the O-arm in accordance with the ALARA principle helped to significantly reduce the radiation exposure and should be routinely used for O-arm-assisted cementoplasty procedures.
CONCLUSIONS: This study details technical aspects and settings that may help users of the O-arm to decrease radiation exposure to patients and surgeons alike, especially in cementoplasty procedures, as well as in other procedures performed under O-arm guidance.
METHODS:
摘要：
背景：三维（3D）导航已成为脊柱手术中的常规应用，允许更准确和安全的程序。然而,与使用成像相关的辐射暴露是一个悬而未决的问题，有关它的信息相对稀缺。“尽可能低的合理可实现”（ALARA）原则旨在尽可能降低患者的辐射暴露。这项研究的目的是比较与在标准设置中使用O形臂相关的有效剂量与经皮骨成形术期间剂量减少的适应特征。
方法：从2021年3月至2022年10月，前瞻性纳入了所有使用O形臂进行导航经皮骨水泥成形术的连续患者。人口统计,Operative,辐照，并收集了放射学数据。主要结果是有效剂量（E）毫西弗（mSv）。次要结果是癌症的绝对风险（AR），相当于全身暴露的百分比，手术时间,以及根据Garnier的放射学结果.在A组中,患者在O形臂的标准设置下进行手术，而在B组中，视野上的导航，准直,使用低剂量设置。
结果：本研究共纳入70例患者：A组43例，B组27例。手术109个椎骨：A组59个，B组50个。A组的平均E明显高于B组（9.94和4.34mSv，分别；P<0.01）。与3D相关的E遵循相同的趋势(7.82和3.97mSv，分别)，二维相关E(2.12和0.37mSv，分别；P<0.01）。A组平均AR也显著高于B组(分别为5.10-4%和2.10-4%;P<0.01)。两组手术时间相似，但A组的放射学结果满意率高于B组（95％和84％，分别为；P=0.11)，我们发现水泥渗漏率相似(22%和24%，分别为；P=0.71）。
结论：根据ALARA原则应用O形臂的设置有助于显著减少辐射暴露，应常规用于O形臂辅助骨水泥成形术。
结论：这项研究详细介绍了技术方面和设置，可以帮助O形臂的使用者减少患者和外科医生的辐射暴露。尤其是在骨水泥成形术中，以及在O形臂指导下执行的其他程序。
方法：
方法：从2021年3月至2022年10月，前瞻性纳入了所有使用O形臂进行导航经皮骨水泥成形术的连续患者。人口统计,Operative,辐照，并收集了放射学数据。主要结果是有效剂量（E）毫西弗（mSv）。次要结果是癌症的绝对风险（AR），相当于全身暴露的百分比，手术时间,以及根据Garnier的放射学结果.在A组中,患者在O形臂的标准设置下进行手术，而在B组中，视野上的导航，准直,使用低剂量设置。
结果：本研究共纳入70例患者：A组43例，B组27例。手术109个椎骨：A组59个，B组50个。A组的平均E明显高于B组（9.94和4.34mSv，分别；P<0.01）。与3D相关的E遵循相同的趋势(7.82和3.97mSv，分别)，二维相关E(2.12和0.37mSv，分别；P<0.01）。A组平均AR也显著高于B组(分别为5.10-4%和2.10-4%;P<0.01)。两组手术时间相似，但A组的放射学结果满意率高于B组（95％和84％，分别为；P=0.11)，我们发现水泥渗漏率相似(22%和24%，分别为；P=0.71）。
结论：根据ALARA原则应用O形臂的设置有助于显著减少辐射暴露，应常规用于O形臂辅助骨水泥成形术。
结论：这项研究详细介绍了技术方面和设置，可以帮助O形臂的使用者减少患者和外科医生的辐射暴露。尤其是在骨水泥成形术中，以及在O形臂指导下执行的其他程序。
方法：
