Radiation exposure to staff members during traction X-rays

Abstract

BackgroundDetermining the flexibility of a scoliosis curve is impor-tant, during both conservative and surgical management,and traction x-rays of the patient’s spine are frequentlydone as part of this evaluation. The traction x-ray is donewith the patient in the supine position, and with staffmembers pulling on the patient’s arms and legs. The useof staff to produce the traction radiograph has two majordisadvantages: the pull on the arms and legs is not stan-dardized, and the staff is exposed to x-ray each time theyperform a radiograph. Ingegno [1] determined that expo-sure to personnel applying arm traction, for cervical radio-graphs, was 0.01mGy. But there are few studies that assessthe radiation exposure to staff during imaging for AIS. Ithas been determined that a typical spinal radiographexposes the patient to 3.2 (+/-1.6) mGy of radiation. [2]AimThe aim of this study was to measure the amount ofradiation a staff member is exposed to while participat-ing in a traction x-ray of a patient with AIS.MethodsThe x-ray table was set up and a phantom block of plasticwas used to provide the same x-ray scatter as a humanbody. An electronic x-ray survey detector was used at thehead and foot of the table, in the same position that a staffmember’s head would be during traction. Radiographswere taken, and measurements of the amount of scatterwere recorded.ResultsThe scatter produced was 0.003 to 0.009 mGy at thelevel of the staff member’s head. Given that staff wears alead apron, the torso dose would be negligible, so theexposure to the eyes and thyroid would be the mostclinically important.ConclusionThe recommended limit of exposure to the eyes for a staffmember is 150 mGy per year [2]. With the exposure thatwe measured, the staff member would not reach this limituntil they performed 17,000 to 50,000 procedures. How-ever, since this dose of x-ray to the staff member has notherapeutic benefits, it should still be reduced wheneverpossible.