Knowledge and Attitude Regarding Radiation Exposure Among Spine Surgeons in Latin America

Abstract

Background: Spine surgeons are exposed to high amounts of radiation from fluoroscopic procedures during their lifetime. In this study, we evaluated spine surgeons' knowledge of and attitude regarding radiation exposure during spine surgery.

Methods: We developed a questionnaire including questions about surgeons' characteristics and knowledge of and attitude regarding radiation exposure during spine surgery. A survey was performed with the members of AOSpine Latin America. The main variables studied were specialty, years of experience, surgeon's position during fluoroscopy, and practices to reduce the patient's and surgeon's radiation exposure during surgery. The results were analyzed and compared among different specialties, levels of experience, and countries of origin.

Results: The questionnaire was answered by 371 members of AOSpine Latin America from different countries. The sample was mostly from orthopedic surgeons (57.1%) and surgeons in practice for longer than 10 years (54.2%). Thyroid lead protection was used by 64.2% of the spine surgeons, lead glasses by 20.2%, and lead gloves by 7%. A dosimeter badge was never or only rarely used by 75.7%. The correct answer for surgeon position during lateral lumbar fluoroscopy was reported by only one-third of the surgeons. The reported rate of thyroid protector use was higher in surgeons from Brazil and Colombia compared with surgeons from Mexico and Argentina (P < 0.001), whereas the use of pulsed-mode fluoroscopy was higher in Mexico and Argentina compared with Brazil and Colombia (P < 0.0001).

Conclusions: Future efforts toward implementing educational programs in Latin America focused on safety strategies are needed to minimize intraoperative radiation exposure.

Keywords: Attitude; Knowledge; Neurosurgeon; Orthopedic surgeon; Patient safety; Radiation exposure; Spine.