Radiation Exposure During Percutaneous Endoscopic Lumbar Discectomy: Interlaminar versus Transforaminal
06 September 2018 (online)
Introduction: Percutaneous endoscopic lumbar discectomy (PELD) relies heavily on fluoroscopy guidance, therefore medical staff exposure to radiation has become an important issue. The purpose of this study was to determine the radiation dose and time to which the surgeons are exposed during PELD and to compare both parameters in the transforaminal (TF) and interlaminar (IL) approaches. Although they are considerably different, they may be wrongly considered together.
Methods: A retrospective evaluation of the last 20 PELD performed by the authors is presented. Patients were distributed in 2 groups. Six (1F, 5M) patients were submitted to IL-PELD and 14 (6F, 8M) to TF-PELD. Fluoroscopy reports were obtained from patients’ records, all in the same C-Arm device and software mode. Groups were compared using unpaired T Test.
Results: The IL group showed an average radiation of 8.37 + 4.21 mGy and 11.1 + 5.45 sec while the TF group showed an average radiation of 28.92 + 7.56 mGy and 42 + 16.64 sec. The p-value for radiation was 0.0000036 and for time was 0.00027.
Conclusions: IL-PELD requires less amount and time of radiation than TF-PELD. Studies that concern radiation required for minimally invasive spine surgeries should consider the PELD approaches separately.