Neuronavigation Assistance. Decreased Radiation Exposure during Spinal Surgery in Patients with Severe Combined Trauma
The results of studies of intraoperative x-ray radiation with the participation of two groups are presented: the main database using a neuronavigation group and a control group where standard 2D fluoroscopy was used. The radiation load on the operating surgery and operating supporting staff was estimated. Stryker iNtellect ENT Second Generation Navigation for the Injured of RFD Ziehm Vision Core and Optical Converters for the Injured of the Control Group. Variants of visualization using an electron-optical transducer are especially important for minimally invasive procedure where instrumentation is performed percutaneously without direct anatomical control in contrast to open procedures or work with misrepresented anatomical structures in case of injuries. Biplanar fluoroscopy was one of the first methods of intraoperative imaging in real time as well as one of the most advanced technologies in orthopedic and spinal surgery. However, radiation exposure from intraoperative fluoroscopy remains a serious problem for patients, surgeons and supporting staff. The negative effects of ionizing radiation lead to cell damage through the induction of deoxyribonucleic acid (DNA) and the release of reactive oxygen species. In this regard, cell death or genome instability occurs which leads to various radiation-related pathologies. It was found that the use of neuronavigation programs can reduce the number of errors, reduce intraoperative trauma and significantly reduce the intraoperative radiation load on the injured, operating surgical and operating supporting staff. The large-scale introduction of navigation technologies will reduce or eliminate the harmful effects of ionizing radiation on the injured and medical personnel.
