| CT angiography for anterior lumbar spine access: high radiation exposure and low clinical relevance. | |
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MedLine Citation:
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PMID: 20824406 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Some spine surgeons perform CT angiography for detailed planning of anterior access to the lumbar spine. However, the value of this imaging method and its influence on surgeons' decisions are unclear. QUESTIONS/PURPOSES: We determined (1) the dose of radiation used in preoperative CT angiography and (2) whether CT angiography affects planning of anterior lumbar spine surgeries. PATIENTS AND METHODS: We assessed preoperative CT angiograms of 28 patients undergoing anterior spine surgery. The level of aortic bifurcation, iliac vein confluence, course of the ascending lumbar vein, central sacral vessels, and any vascular variation were mapped. We determined the effective dose of radiation and recorded whether the preoperative CT angiography influenced surgical planning. RESULTS: We observed variations in the location of the aortic bifurcation and the iliac vein confluence. In 32% of patients, there were accessory renal arteries originating from the aorta; 7% had a rudimentary persistent left-sided caval vein. The findings did not change the plan for surgery in any patient. We detected high organ radiation dosages (mSv) for the stomach (63 mSv), liver (58 mSv), urinary bladder (47 mSv), and colon (46 mSv); other high exposure dosages involved the lungs, bone marrow, ovaries, and uterus. CONCLUSIONS: About one in 1919 men and one in 2971 women undergoing CT angiography therefore are expected to have colon cancer develop, and one in 2781 men and one in 2856 women are expected to have cancer of the urinary bladder develop. CT angiography is of low value for preoperative planning for anterior access to the lumbar spine and should be avoided to prevent radiation-induced damage. LEVEL OF EVIDENCE: Level II, diagnostic study. |
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Authors:
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Michaela Gstöttner; Bernhard Glodny; Johannes Petersen; Martin Thaler; Christian Michael Bach |
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Publication Detail:
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Type: Journal Article Date: 2010-09-08 |
Journal Detail:
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Title: Clinical orthopaedics and related research Volume: 469 ISSN: 1528-1132 ISO Abbreviation: Clin. Orthop. Relat. Res. Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-02-03 Completed Date: 2011-03-24 Revised Date: 2011-04-20 |
Medline Journal Info:
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Nlm Unique ID: 0075674 Medline TA: Clin Orthop Relat Res Country: United States |
Other Details:
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Languages: eng Pagination: 819-24 Citation Subset: AIM; IM |
Affiliation:
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Department of Orthopaedic Surgery, Innsbruck Medical University, Anichstr 35, Innsbruck, Austria. michaela.gstoettner@gmx.at |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angiography Blood Vessels / pathology Dose-Response Relationship, Radiation Female Genetic Variation Humans Imaging, Three-Dimensional Lumbar Vertebrae / blood supply, radiography*, surgery* Male Patient Care Planning Radiation Dosage Radiation Injuries / etiology*, prevention & control Retrospective Studies Tomography, Spiral Computed / adverse effects* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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