Assessment of the Radiation Exposure of Surgeons and Patients During a Lumbar Microdiskectomy and a Cervical Microdiskectomy: A French Prospective Multicenter Study

OBJECTIVE: Cervical and lumbar disk herniations are the most frequently carried out procedures in spinal surgery. Often, a few snapshots during the procedure are necessary to validate the level or to position the implant. The objective of this study is to quantitatively estimate the radiation received by a spine surgeon and patient during a low-dose radiation procedure. METHODS: We conducted a prospective multicenter study in France from November 2014 to April 2015. Four spine centers were monitored for radiation received by surgeons during interventions for lumbar disk herniation and cervical disk herniation. RESULTS: A total of 134 patients were included. For lumbar disk herniation, the average exposure for the surgeon was 0.584 mu Sv on the chest, 5.291 mu Sv on the lens, and 9.295 mu Sv on the hands per procedure. For these procedures, the dose area product (DAP) was 94.2 +/- 198.4 cGy.cm(2), and the fluoroscopic time was 10.2 +/- 16.9 seconds. For a herniated cervical disk, the average exposure for the surgeon was 0.122 mu Sv on the chest, 3.106 mu Sv on the lens, and 7.143 mu Sv on the hands per procedure. For these procedures, the DAP was 35.7 +/- 72.1 cGy.cm(2), and the fluoroscopic time was 19.7 +/- 13.7 seconds. CONCLUSIONS: Exposure to x-rays for surgeons and patients during surgery for lumbar disk herniation is higher than during surgery for cervical herniation disk. Our results show that radiation exposure to the spine surgeon is still far below the annual dose limits.