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72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

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Radiation doses of sliding gantry CT-based as compared to mobile cone-beam CT-based navigated pedicle screw placement in a homogenous cohort

Strahlungs-Dosis des sliding gantry CTs im Vergleich zum mobilen cone-beam CT bei der navigierten Anlage von Pedikel-Schrauben in einer homogenen Kohorte

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  • presenting/speaker Sebastian Ille - Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, München, Deutschland
  • Lea Baumgart - Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, München, Deutschland
  • Bernhard Meyer - Department of Neurosurgery, Technical University of Munich, Germany, School of Medicine, Klinikum rechts der Isar, München, Deutschland
  • Sandro Krieg - Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocP117

doi: 10.3205/21dgnc405, urn:nbn:de:0183-21dgnc4051

Published: June 4, 2021

© 2021 Ille et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Today, multiple solutions for navigation-guided pedicle screw placement are available. For the present study, we compared the applied radiation doses of sliding gantry CT-based (SGCT) and mobile cone-beam CT-based (CBCT) pedicle screw placement for spinal instrumentation.

Methods: We analyzed 183 and 54 patients who underwent SGCT-based using an automated radiation dose adjustment or standard CBCT-based pedicle screw placement for spinal instrumentation at our department between 06/2019 and 01/2020, respectively.

Results: Baseline characteristics including the number of screws per patient and the number of instrumented levels did not differ between the two groups. Although the accuracy of screw placement according to Gertzbein-Robbins classification did not differ between the two groups, more screws had to be revised intraoperatively in the CBCT group (SGCT: 39, 2.7% vs. CBCT: 23, 6.0%; p=0.0036). Mean ± standard deviation radiation doses [mGy*cm] for the first (SGCT: 484.0±201.1, CBCT: 687.4±188.5; p<0.0001), second (SGCT: 515.8±216.3, CBCT: 658.3±220.1; p<0.0001), third (SGCT: 531.3±237.5, CBCT: 641.6±177.3; p=0.0140), and the total of all scans (SGCT: 1216.9±699.3, CBCT: 2000.3±921.0; p<0.0001) were significantly lower in the SGCT group. The same applies to radiation doses per level (SGCT: 461.9±429.3, CBCT: 1004.1±905.1; p<0.0001) and radiation doses per screw (SGCT: 172.6±110.1, CBCT: 349.6±273.4; p<0.0001).

Conclusion: The present results show that the applied radiation doses are significantly lower using a SGCT for navigated pedicle screw placement in spinal instrumentation. A modern CT scanner on a sliding gantry leads to lower doses, especially through automated 3D radiation dose adjustment.