{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T01:25:12Z","timestamp":1782350712542,"version":"3.54.5"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>The level of radiation awareness by surgeons and residents in spinal surgery does not match the ubiquity of fluoroscopy in operating rooms in the United States. The present method of monitoring radiation exposure may contribute to the current deficiency in radiation awareness. Current dosimeters involve a considerable lag from the time that the surgical team is exposed to radiation to the time that they are provided with that exposure data. The objective of the current study was to assess the feasibility of monitoring radiation exposure in operating room personnel during lateral transpsoas lumbar interbody fusion (LLIF) and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) procedures by using a wearable personal device with real-time feedback.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Operating room staff participating in minimally invasive surgical procedures under a single surgeon during a 6-month period were prospectively enrolled in this study. All radiation dose exposures were recorded for each member of the surgical team (surgeon, assistant surgeon, scrub nurse, and circulating nurse) using a personal dosimeter (DoseAware). Radiation doses were recorded in microsieverts (\u03bcSv). Comparisons between groups were made using ANOVA with the Tukey post hoc test and Student t-test.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Thirty-nine patients underwent interbody fusions: 25 underwent LLIF procedures (14 LLIF alone, 11 LLIF with percutaneous screw placement [PSP]) and 14 underwent MI-TLIF. For each operative scenario per spinal level, the surgeon experienced significantly higher (p &lt; 0.035) average radiation exposure (LLIF: 167.9 \u03bcSv, LLIF+PSP: 424.2 \u03bcSv, MI-TLIF: 397.9 \u03bcSv) than other members of the team, followed by the assistant surgeon (LLIF: 149.7 \u03bcSv, LLIF+PSP: 242.3 \u03bcSv, MI-TLIF: 274.9 \u03bcSv). The scrub nurse (LLIF: 15.4 \u03bcSv, LLIF+PSP: 125.7 \u03bcSv, MI-TLIF: 183.0 \u03bcSv) and circulating nurse (LLIF: 1.2 \u03bcSv, LLIF+PSP: 9.2 \u03bcSv, MI-TLIF: 102.3 \u03bcSv) experienced significantly lower exposures. Radiation exposure was not correlated with the patient\u2019s body mass index (p \u2265 0.233); however, it was positively correlated with increasing patient age (p \u2264 0.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Real-time monitoring of radiation exposure is currently feasible and shortens the time between exposure and the availability of information regarding that exposure. A shortened feedback loop that offers more reliable and immediate data would conceivably raise the level of concern for radiation exposure in spinal surgeries and could alter patterns of behavior, leading to decreased exposures. Further studies are ongoing to determine the effect of real-time dosimetry in spinal surgery.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2019.11.spine19448","type":"journal-article","created":{"date-parts":[[2020,2,7]],"date-time":"2020-02-07T23:01:02Z","timestamp":1581116462000},"page":"817-823","source":"Crossref","is-referenced-by-count":21,"title":["Surgeon and staff radiation exposure in minimally invasive spinal surgery: prospective series using a personal dosimeter"],"prefix":"10.3171","volume":"32","author":[{"given":"Jakub","family":"Godzik","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George M.","family":"Mastorakos","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine, Scottsdale, Arizona;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gautam","family":"Nayar","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Department of Neurosurgery, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William D.","family":"Hunter","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, CaroMont Health Regional Medical Center, Gastonia, North Carolina; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis M.","family":"Tumial\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona;"},{"name":"Spine Group Arizona, HonorHealth, Greenbaum Surgical Specialty Hospital, Scottsdale, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Occup Med (Lond)","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1093\/occmed\/kql114","article-title":"Occupational risk factors and reproductive health of women","volume":"56","author":"Fig\u00e0-Talamanca I","year":"2006","unstructured":"Fig\u00e0-Talamanca I: Occupational risk factors and reproductive health of women. Occup Med (Lond) 56:521\u2013531, 200610.1093\/occmed\/kql114"},{"key":"b2","series-title":"Epidemiol Rev","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1093\/oxfordjournals.epirev.a018037","article-title":"Reproductive problems among women health care workers: epidemiologic evidence and preventive strategies","volume":"22","author":"Fig\u00e0-Talamanca I","year":"2000","unstructured":"Fig\u00e0-Talamanca I: Reproductive problems among women health care workers: epidemiologic evidence and preventive strategies. Epidemiol Rev 22:249\u2013260, 20001121837610.1093\/oxfordjournals.epirev.a018037"},{"key":"b3","series-title":"PLoS One","doi-asserted-by":"publisher","first-page":"e95233","DOI":"10.1371\/journal.pone.0095233","article-title":"Surgeons\u2019 exposure to radiation in single- and multi-level minimally invasive transforaminal lumbar interbody fusion; a prospective study","volume":"9","author":"Funao H","year":"2014","unstructured":"Funao H, Ishii K, Momoshima S, Iwanami A, Hosogane N, Watanabe K, : Surgeons\u2019 exposure to radiation in single- and multi-level minimally invasive transforaminal lumbar interbody fusion; a prospective study. PLoS One 9:e95233, 201410.1371\/journal.pone.009523324736321"},{"key":"b4","series-title":"Epidemiology","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1097\/00001648-199805000-00010","article-title":"Adverse reproductive outcomes among women exposed to low levels of ionizing radiation from diagnostic radiography for adolescent idiopathic scoliosis","volume":"9","author":"Goldberg MS","year":"1998","unstructured":"Goldberg MS, Mayo NE, Levy AR, Scott SC, Po\u00eetras B: Adverse reproductive outcomes among women exposed to low levels of ionizing radiation from diagnostic radiography for adolescent idiopathic scoliosis. Epidemiology 9:271\u2013278, 1998958341810.1097\/00001648-199805000-00010"},{"key":"b5","series-title":"Federal Guidance Report No. 14. Radiation Protection Guidance for Diagnostic and Interventional X-Ray Procedures","author":"Interagency Working Group on Medical Radiation","year":"2014","unstructured":"Interagency Working Group on Medical Radiation: Federal Guidance Report No. 14. Radiation Protection Guidance for Diagnostic and Interventional X-Ray Procedures. Washington, DC: U.S. Environmental Protection Agency, 2014 (https:\/\/www.epa.gov\/radiation\/federal-guidance-report-no-14-radiation-protection-guidance-diagnostic-and-interventional) [Accessed December 6, 2019]"},{"key":"b6","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1227\/NEU.0000000000000913","article-title":"Surgical outcomes for minimally invasive vs open transforaminal lumbar interbody fusion: an updated systematic review and meta-analysis","volume":"77","author":"Khan NR","year":"2015","unstructured":"Khan NR, Clark AJ, Lee SL, Venable GT, Rossi NB, Foley KT: Surgical outcomes for minimally invasive vs open transforaminal lumbar interbody fusion: an updated systematic review and meta-analysis. Neurosurgery 77:847\u2013874, 201510.1227\/NEU.000000000000091326214320"},{"key":"b7","series-title":"Int J Sports Physiol Perform","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1123\/ijspp.2018-0128","article-title":"Real-time feedback on mechanical power output: facilitating crew rowers\u2019 compliance with prescribed training intensity","volume":"14","author":"Lintmeijer LL","year":"2018","unstructured":"Lintmeijer LL, van Soest AJ, Robbers FS, Hofmijster MJ, Beek PJ: Real-time feedback on mechanical power output: facilitating crew rowers\u2019 compliance with prescribed training intensity. Int J Sports Physiol Perform 14:303\u2013309, 201810.1123\/ijspp.2018-0128"},{"key":"b8","series-title":"J Vasc Surg","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1016\/j.jvs.2013.02.032","article-title":"Radiation exposure to operating room personnel and patients during endovascular procedures","volume":"58","author":"Mohapatra A","year":"2013","unstructured":"Mohapatra A, Greenberg RK, Mastracci TM, Eagleton MJ, Thornsberry B: Radiation exposure to operating room personnel and patients during endovascular procedures. J Vasc Surg 58:702\u2013709, 20132381030010.1016\/j.jvs.2013.02.032"},{"key":"b9","series-title":"Orthop Traumatol Surg Res","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1016\/j.otsr.2014.09.016","article-title":"Real-time dosimetry reduces radiation exposure of orthopaedic surgeons","volume":"100","author":"M\u00fcller MC","year":"2014","unstructured":"M\u00fcller MC, Welle K, Strauss A, Naehle PC, Pennekamp PH, Weber O, : Real-time dosimetry reduces radiation exposure of orthopaedic surgeons. Orthop Traumatol Surg Res 100:947\u2013951, 20142545945510.1016\/j.otsr.2014.09.016"},{"key":"b10","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"2985","DOI":"10.1016\/j.spinee.2014.06.003","article-title":"Intraoperative fluoroscopy, portable X-ray, and CT: patient and operating room personnel radiation exposure in spinal surgery","volume":"14","author":"Nelson EM","year":"2014","unstructured":"Nelson EM, Monazzam SM, Kim KD, Seibert JA, Klineberg EO: Intraoperative fluoroscopy, portable X-ray, and CT: patient and operating room personnel radiation exposure in spinal surgery. Spine J 14:2985\u20132991, 201410.1016\/j.spinee.2014.06.00324912118"},{"key":"b11","series-title":"Radiat Prot Dosimetry","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1093\/rpd\/ncv090","article-title":"Reduction of occupational radiation dose in staff at the cardiac catheterisation laboratory by protective material placed on the patient","volume":"165","author":"Ordiales JM","year":"2015","unstructured":"Ordiales JM, Nogales JM, S\u00e1nchez-Casanueva R, Vano E, Fern\u00e1ndez JM, \u00c1lvarez FJ, : Reduction of occupational radiation dose in staff at the cardiac catheterisation laboratory by protective material placed on the patient. Radiat Prot Dosimetry 165:272\u2013275, 201510.1093\/rpd\/ncv09025848096"},{"key":"b12","series-title":"J Vasc Interv Radiol","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.jvir.2013.08.015","article-title":"Effect of real-time radiation dose feedback on pediatric interventional radiology staff radiation exposure","volume":"25","author":"Racadio J","year":"2014","unstructured":"Racadio J, Nachabe R, Carelsen B, Racadio J, Hilvert N, Johnson N, : Effect of real-time radiation dose feedback on pediatric interventional radiology staff radiation exposure. J Vasc Interv Radiol 25:119\u2013126, 201410.1016\/j.jvir.2013.08.01524094673"},{"key":"b13","series-title":"Cardiovasc Intervent Radiol","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.1007\/s00270-010-9945-4","article-title":"Staff radiation doses in a real-time display inside the angiography room","volume":"33","author":"Sanchez R","year":"2010","unstructured":"Sanchez R, Vano E, Fernandez JM, Gallego JJ: Staff radiation doses in a real-time display inside the angiography room. Cardiovasc Intervent Radiol 33:1210\u20131214, 201010.1007\/s00270-010-9945-4"},{"key":"b14","series-title":"Pain Pract","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1111\/papr.12251","article-title":"Coaching reduced the radiation dose of pain physicians by half during interventional procedures","volume":"15","author":"Slegers AS","year":"2015","unstructured":"Slegers AS, G\u00fcltuna I, Aukes JA, van Gorp EJ, Blommers FM, Niehof SP, : Coaching reduced the radiation dose of pain physicians by half during interventional procedures. Pain Pract 15:400\u2013406, 20152535434210.1111\/papr.12251"},{"key":"b15","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1386","DOI":"10.1097\/BRS.0b013e31828705ad","article-title":"2013 Young Investigator Award winner: How safe is lateral lumbar interbody fusion for the surgeon? A prospective in vivo radiation exposure study","volume":"38","author":"Taher F","year":"2013","unstructured":"Taher F, Hughes AP, Sama AA, Zeldin R, Schneider R, Holodny EI, : 2013 Young Investigator Award winner: How safe is lateral lumbar interbody fusion for the surgeon? A prospective in vivo radiation exposure study. Spine (Phila Pa 1976) 38:1386\u20131392, 201310.1097\/BRS.0b013e31828705ad"},{"key":"b16","series-title":"J Radiol Prot","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1088\/0952-4746\/28\/2\/R02","article-title":"New ICRP recommendations","volume":"28","author":"Wrixon AD","year":"2008","unstructured":"Wrixon AD: New ICRP recommendations. J Radiol Prot 28:161\u2013168, 20081849598310.1088\/0952-4746\/28\/2\/R02"},{"key":"b17","series-title":"Clin Orthop Relat Res","doi-asserted-by":"publisher","first-page":"1738","DOI":"10.1007\/s11999-014-3503-3","article-title":"Does less invasive spine surgery result in increased radiation exposure? A systematic review","volume":"472","author":"Yu E","year":"2014","unstructured":"Yu E, Khan SN: Does less invasive spine surgery result in increased radiation exposure? A systematic review. Clin Orthop Relat Res 472:1738\u20131748, 201410.1007\/s11999-014-3503-324549771"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/32\/6\/article-p817.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/32\/6\/article-p817.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/32\/6\/article-p817.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T22:51:26Z","timestamp":1681599086000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/32\/6\/article-p817.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6]]},"references-count":17,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2019.11.spine19448","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2020,6]]}}}