Radiation Exposure during Percutaneous Endoscopic Lumbar Discectomy: Interlaminar versus Transforaminal
Arq. bras. neurocir; 38 (1), 2019
Publication year: 2019
Objective 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 the
amount of 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 performed with the same C-Arm device and software mode.
Groups were compared using unpaired t-test.
Results The IL group showed an average radiation exposure of 8.37 4.21 mGy and
duration of 11.1 5.45 seconds, while the TF group showed an average radiation
exposure of 28.92 7.56 mGy and duration of 42 16.64 seconds. The p-value for
radiation was 0.0000036, and for time it was 0.00027.
Conclusions Interlaminar PELD requires a lower radiation dose and a shorter amount
of exposure than TF-PELD. Studies that concern radiation required for minimallyinvasive
spine surgeries should consider the PELD approaches separately.