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Using a dedicated spine radiology technologist is associated with reduced fluoroscopy time, radiation dose, and surgical time in pediatric spinal deformity surgery

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Abstract

Study design

Retrospective comparative study

Objectives

The goal of this study was to investigate fluoroscopy time and radiation exposure during pediatric spine surgery using a dedicated radiology technologist with extensive experience in spine operating rooms.

Summary of background data

Repetitive use of intraoperative fluoroscopy during posterior spinal fusion (PSF) exposes the patient, surgeon, and staff to radiation.

Methods

Retrospective review was conducted on patients with posterior spinal fusion (PSF) of ≥ 7 levels for adolescent idiopathic scoliosis (AIS) at a pediatric hospital from 2015 to 2019. Cases covered by the dedicated radiology technologist (dedicated group) were compared to all other cases (non-dedicated group). Surgical and radiologic variables were compared between groups.

Results

230 patients were included. 112/230 (49%) were in the dedicated group and 118/230 (51%) were in the non-dedicated group. Total fluoroscopy time was significantly reduced in cases with the dedicated technologist (46 s) compared to those without (69 s) (p = 0.001). Radiation dose area product (DAP) and air kerma (AK) were reduced by 43% (p < 0.001) and 42% (p < 0.001) in the dedicated group, respectively. The dedicated group also had reduced total surgical time (4.1 vs. 3.5 h; p < 0.001) and estimated blood loss (447 vs. 378 cc (; p = 0.02). Multivariate regression revealed that using a dedicated radiology technologist was independently associated with decreased fluoroscopy time (p = 0.001), DAP (p < 0.001), AK (p < 0.001), surgical time (p < 0.001), and EBL (p = 0.02).

Conclusions

In AIS patients undergoing PSF, using a dedicated radiology technologist was independently associated with significant reductions in fluoroscopy time, radiation exposure, surgical time, and EBL. This adds to the growing body of research demonstrating that the experience level of the team—not just that of the surgeon—is necessary for optimal outcomes.

Level of evidence

III

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Funding

None of the authors received financial support for this study.

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Authors and Affiliations

  1. Keck School of Medicine at University of Southern California, Los Angeles, CA, USA

    Ali A. Siddiqui MD, Lindsay M. Andras MD, Rajan Murgai MD, Kenneth D. Illingworth MD, Vernon T. Tolo MD, Skorn Ponrartana MD & David L. Skaggs MD, MMM

  2. Children’s Orthopaedic Center, Children’s Hospital of Los Angeles, 4650 Sunset Blvd, MS#69, Los Angeles, CA, 90027, USA

    Ali A. Siddiqui MD, Lindsay M. Andras MD, Kyle K. Obana BA, Rajan Murgai MD, Kenneth D. Illingworth MD, Vernon T. Tolo MD, Michael Mariscal, Skorn Ponrartana MD & David L. Skaggs MD, MMM

  3. University of FL College of Medicine—Jacksonville, Jacksonville, FL, USA

    Ali A. Siddiqui MD

  4. University of Hawaii, Honolulu, HI, USA

    Kyle K. Obana BA

  5. University of Miami, Miami, FL, USA

    Rajan Murgai MD

Authors
  1. Ali A. Siddiqui MD
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  2. Lindsay M. Andras MD
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  3. Kyle K. Obana BA
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  4. Rajan Murgai MD
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  5. Kenneth D. Illingworth MD
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  6. Vernon T. Tolo MD
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  7. Michael Mariscal
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  8. Skorn Ponrartana MD
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  9. David L. Skaggs MD, MMM
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Contributions

AAS: Data collection, manuscript writing, final approval of manuscript; KKO: Data collection, manuscript writing, final approval of manuscript; RM: Data collection, final approval of manuscript; LMA: Study design, final approval of manuscript; KDI: Study design, final approval of manuscript; VTT: Study design, final approval of manuscript; MM: Study design, final approval of manuscript; SP: Study design, final approval of manuscript; DLS: Study design, final approval of manuscript.

Corresponding author

Correspondence to David L. Skaggs MD, MMM.

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Ethical approval

This study has been carried out with approval from the Institutional Review Board at Children’s Hospital Los Angeles.

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Siddiqui, A.A., Andras, L.M., Obana, K.K. et al. Using a dedicated spine radiology technologist is associated with reduced fluoroscopy time, radiation dose, and surgical time in pediatric spinal deformity surgery. Spine Deform 9, 85–89 (2021). https://doi.org/10.1007/s43390-020-00183-5

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  • DOI: https://doi.org/10.1007/s43390-020-00183-5

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