Introduction: Commonly employed imaging techniques include plain radiographs, fluoroscopy, and computed tomography (CT), each enhancing surgical precision, improving patient safety, reducing operative time, and enabling less invasive approaches. Over the past two decades, efforts to address radiation safety have led to improved practices. Research has demonstrated that heightened awareness alone, even without protocol changes, can significantly reduce radiation exposure.
This review discusses the various preoperative and intraoperative imaging "recipes" available, offering surgeons a platform to tailor these options in consultation with patients. The article also explains measurement units and their relevance, providing a comprehensive guide that supports surgeons in making informed decisions based on the imaging capabilities of their institutions.
Methods: This review will categorize imaging techniques and evaluate the effectiveness of newer technologies such as low-dose CT, intraoperative 3D imaging, and robotic-assisted navigation. Emphasis will be placed on studies that outline radiation exposure levels and strategies to mitigate risks.
Results: We synthesized extensive findings from the literature, highlighting key evidence-based recommendations and recent technological advancements. We found that low-dose CT protocols can reduce patient radiation exposure by up to 90% during preoperative and intraoperative imaging, with comparable reductions available for surgeons and staff wearing proper protective equipment. Additionally, EOS imaging systems offer a promising alternative, lowering preoperative radiation exposure by around 50% compared to traditional X-rays. These findings represent part of a broader analysis aimed at equipping surgeons with a range of options to optimize radiation safety and efficacy in their practices.
Conclusion : This review outlines strategies for optimizing imaging protocols to minimize radiation risks for patients, surgeons, and staff. By understanding the available technologies and their associated exposures, spine surgeons can make informed decisions that prioritize safety and efficacy in surgical planning and execution. Specific imaging protocols that demonstrate reduced radiation exposure while maintaining surgical precision will be discussed.
.jpg)
