DOS 2019

DOS Kongressen 2019 · 189 EOS, O-arm and standard spine radiographs; what is the cumulative radiation exposure during current scoliosis management? Ari Demirel, Peter Heide Pedersen, Søren Peter Eiskjær Orthopaedics Department, Aalborg University Hospital Background: During the course of treatment for adult idiopathic scoliosis (AIS), patients are subjected to repeated radiological exposure. Only a few studies have evaluated the total absorbed radiation dose during follow-up for scoliosis. To the best of our knowledge, this is the first study to evaluate total radiation dose exposure from all modalities for a cohort of AIS patients. Purpose / Aim of Study: The aim of this study was to determine the radiation exposure of AIS patients and to compare follow-up algorithms among different international spine centers. Materials and Methods: A retrospective review on radiation exposure of pa- tients treated for AIS. Inclusions: patients followed for AIS at our institution from 2013-2016 without neuromuscular disease. The O-arm cone-beam CT scan- ner was used for 3D navigation in all surgically managed patients, low dose pro- tocols were used (70kVp, 80mAs). A survey asking for information on radiologi- cal algorithms and imaging frequencies was sent to a number of international spine centers. Findings / Results: 61 patients were included, 19 were treated conservatively (M/F: 6/13) and 42 surgically (M/F: 11/31). Median follow up time for the con- servative group was 8 (range 0-51) months and 37 (range 13-163) months for the surgical group. Median number of X-rays/EOS were; 2 (range 0-20)/ 2 (range 0-17) for the conservative group and 15 (range 2-57)/11(range 0-26) for the surgery group. Patients undergoing surgery received a median cumu- lative radiation dose of 10.31mSv (range 3.79-20.43) vs. a median dose of 1.09mSv (range 0.22-7.17) for those treated conservatively. Approximately 25% (39.04/161.82mSv) of total intraoperative radiation dose for all patients was a result of O- arm 2D fluoroscopy. The results of the questionnaire showed great variety of radiological follow-up algorithms among 8 spine centers with- out adherence to any of the published consensus statements. Conclusions: Surgically treated patients were exposed to more, radiation dose than those treated conservatively, owing mainly to intraoperative 3D scans and a larger numbers of radiological follow-up examinations. Further awareness to reduce radiation exposure is warranted in order to decrease potential risk of future radiation-induced malignancy. 145.