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World J Orthop. Jul 18, 2017; 8(7): 524-530
Published online Jul 18, 2017. doi: 10.5312/wjo.v8.i7.524
Radiation exposure and reduction in the operating room: Perspectives and future directions in spine surgery
Ankur S Narain, Fady Y Hijji, Kelly H Yom, Krishna T Kudaravalli, Brittany E Haws, Kern Singh
Ankur S Narain, Fady Y Hijji, Kelly H Yom, Krishna T Kudaravalli, Brittany E Haws, Kern Singh, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL 60612, United States
Author contributions: Narain AS and Singh K determined the topic; Narain AS, Hijji FY, Yom KH, Kudaravalli KT, and Haws BE performed the literature review; Narain AS and Hijji FY drafted the manuscript; Yom KH, Kudaravalli KT, Haws BE and Singh K performed critical revisions of the manuscript; Narain AS, Hijji FY, Yom KH, Kudaravalli KT, Haws BE and Singh K provided final approval of the manuscript before submission.
Conflict-of-interest statement: No benefits in any form have been or will be received from any commercial party related directly or indirectly to the subject of this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kern Singh, MD, Professor, Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St, Suite #300, Chicago, IL 60612, United States. kern.singh@rushortho.com
Telephone: +1-312-4322373 Fax: +1-708-4095179
Received: January 19, 2017
Peer-review started: January 19, 2017
First decision: April 14, 2017
Revised: April 21, 2017
Accepted: May 3, 2017
Article in press: May 5, 2017
Published online: July 18, 2017
Core Tip

Core tip: Intraoperative radiation exposure is a significant concern for patients, surgeons, and operative room staff during spine surgery. All surgeons should practice general radiation safety techniques including shielding, distance, and fluoroscopic dose reduction. New imaging modalities and spinal navigation systems have also been developed to mitigate radiation exposure risk. These modalities include CT-based techniques such as Isocentric Three-Dimensional C-arms and O-Arms. Intraoperative magnetic resonance imaging has also been adapted from the neurosurgical field and is another developing imaging technique. Further research is required to overcome the limitations of these novel technologies in regards to costs and training requirements.