Trial reportPloS one2014
Surgeons' exposure to radiation in single- and multi-level minimally invasive transforaminal lumbar interbody fusion; a prospective study.
Trial report in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed.
- Real-time phase-dependent occupational radiation exposure analysis in full-endoscopic spine surgery.Scientific reports · 2026Article
- Description of Scatter Radiation Exposure to the Eye Lenses and Direct Exposure to the Hands in Orthopedic and Spinal Procedures.Spine surgery and related research · 2026Article
- Feasibility of synthetic CT images for robotic pedicle screw planning and navigation.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Accuracy and Safety of Pedicle Screw Insertion Using Novel Intraoperative Computed Tomography Navigation System for Spinal Fusion Surgery.Spine surgery and related research · 2025Article
- A Novel Intraoperative CT Navigation System for Spinal Fusion Surgery in Lumbar Degenerative Disease: Accuracy and Safety of Pedicle Screw Placement.Journal of clinical medicine · 2024Article
- Intraoperative Radiation Exposure from O-arm-based 3D Navigation in Spine Surgery.Spine surgery and related research · 2023Article
- Free-Hand MIS TLIF without 3D Navigation-How to Achieve Low Radiation Exposure for Both Surgeon and Patient.Journal of clinical medicine · 2023Article
- Marker Screw Utilization for Minimally Invasive Transforaminal Lumbar Interbody Fusion (MS-MIS TLIF): Promises and Advantages.Medicina (Kaunas, Lithuania) · 2023Article
- Protective Attitudes toward Occupational Radiation Exposure among Spine Surgeons in Japan: An Epidemiological Description from the Survey by the Society for Minimally Invasive Spinal Treatment.Medicina (Kaunas, Lithuania) · 2023Article
- Reduction in Radiation Exposure in Minimally Invasive Pedicle Screw Placement Using a Tubular Retractor: A Pilot Study.Tomography (Ann Arbor, Mich.) · 2022Article
- Association of occupational direct radiation exposure to the hands with longitudinal melanonychia and hand eczema in spine surgeons: a survey by the society for minimally invasive spinal treatment (MIST).European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2021Article
- Association between occupational testicular radiation exposure and lower male sex ratio of offspring among orthopedic surgeons.PloS one · 2021Article
- C-arm fluoroscopic-guided subarachnoid block in a super morbidly obese patient.Indian journal of anaesthesia · 2020Article
- Effect of Instrument Navigation on C-arm Radiation and Time during Spinal Procedures: A Clinical Evaluation.International journal of spine surgery · 2020Article
- A new protective method to reduce radiation exposure.Journal of spine surgery (Hong Kong) · 2020Article
- Vertebroplasty with posterior spinal fusion for osteoporotic vertebral fracture using computer-assisted rod contouring system: A new minimally invasive technique.International journal of surgery case reports · 2020Article
- A protective method to reduce radiation exposure to the surgeon during endoscopic lumbar spine surgery.Journal of spine surgery (Hong Kong) · 2019Article
- Observational
- A randomized controlled trial with ≥5 years of follow-up comparing minimally invasive and open transforaminal lumbar interbody fusion in disc herniation at single level.Experimental and therapeutic medicine · 2019Article
- Protecting Surgeons' Fingers from Radiation Exposure during Lumbosacral Selective Nerve Root Block.Spine surgery and related research · 2019Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has widely been developed in patients with lumbar diseases, surgeons risk exposure to fluoroscopic radiation. However, to date, there is no studies quantifying the effective dose during MIS-TLIF procedure, and the radiation dose distribution is still unclear. In this study, the surgeons' radiation doses at 5 places on the bodies were measured and the effective doses were assessed during 31 consecutive 1- to 3-level MIS-TLIF surgeries. The operating surgeon, assisting surgeon, and radiological technologist wore thermoluminescent dosimeter on the unshielded thyroid, chest, genitals, right middle finger, and on the chest beneath a lead apron. The doses at the lens and the effective doses were also calculated. Mean fluoroscopy times were 38.7, 53.1, and 58.5 seconds for 1, 2, or 3 fusion levels, respectively. The operating surgeon's mean exposures at the lens, thyroid, chest, genitals, finger, and the chest beneath the shield, respectively, were 0.07, 0.07, 0.09, 0.14, 0.32, and 0.05 mSv in 1-level MIS-TLIF; 0.07, 0.08, 0.09, 0.18, 0.34, and 0.05 mSv in 2-level; 0.08, 0.09, 0.14, 0.15, 0.36, and 0.06 mSv in 3-level; and 0.07, 0.08, 0.10, 0.15, 0.33, and 0.05 mSv in all cases. Mean dose at the operating surgeon's right finger was significantly higher than other measurements parts (P<0.001). The operating surgeon's effective doses (0.06, 0.06, and 0.07 mSv for 1, 2, and 3 fusion levels) were low, and didn't differ significantly from those of the assisting surgeon or radiological technologist. Revision MIS-TLIF was not associated with higher surgeons' radiation doses compared to primary MIS-TLIF. There were significantly higher surgeons' radiation doses in over-weight than in normal-weight patients. The surgeons' radiation exposure during MIS-TLIF was within the safe level by the International Commission on Radiological Protection's guidelines. The accumulated radiation exposure, especially to surgeon's hands, should be carefully monitored.
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