Biomedical Letters

Radiation exposure and its safety measures in open and minimally invasive transforaminal lumbar inter-body fusion: A literature review

Sujan Maharjan, Li Ming Cheng*

Department of Orthopaedic and Spine Surgery, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China.

Abstract

Radiation is a phenomenon in which the wave emitting from a particular source travels outwards in all directions. There are numerous types of radiations. But one which is mostly harmful to a person in health sector is ionizing radiations generated from X-ray tubes. Spine surgeons are most at risk of this ionizing radiation exposure than others, as there is frequent requirement of fluoroscopy during spine surgeries. Two such procedures are open Transforaminal Lumbar Inter-body Fusion (TLIF) and Minimally Invasive Transforaminal Lumbar Inter-body Fusion (MI-TLIF). Therefore, this paper reviews studies that explored the impact of radiation exposure during open TLIF and MI-TLIF, its related complication and evaluation of occupational hazards to the health workers. Open TLIF and MI-TLIF are the most common procedure of spine surgery which requires intra operative fluoroscopic guidance for the appropriate localization and placement of instrumentation. The length of these procedures increases continuous exposure to the X-rays causing potential short term risks like skin injury and burn, and long term consequences like radiation induced cancers in both patients and surgeons. Although, the clinical benefit of one time procedure outweighs the small radiation risk for the patient, the number of times of exposure increases with each case for the health care provider. However, MI-TLIF has more advantages and is considered to be more beneficial to the patient than Open TLIF making it more popular and widely used. Also, the concern of interest are the findings of different studies, on how to reduce the risk of radiation exposure in surgeons without affecting the efficacy of the procedure.

Keywords: Ionizing Radiations, Fluoroscopy, Open TLIF, MI-TLIF.

Received February 05, 2015 Revised March 03, 2015 Accepted March 26, 2015

*Correspondence: Li Ming Cheng Tel: +86 13701959550 E-mail: limingcheng@tongji.edu.cn