Radiation Exposure during Percutaneous Endoscopic Lumbar Discectomy: Interlaminar versus Transforaminal

Objective Percutaneous endoscopic lumbar discectomy (PELD) relies heavily on fluoroscopy guidance; therefore, medical staff exposure to radiation has become an important issue. The purpose of this study was to determine the radiation dose and the amount of time to which the surgeons are exposed during PELD and to compare both parameters in the transforaminal (TF) and interlaminar (IL) approaches. Although they are considerably different, they may be wrongly considered together. Methods A retrospective evaluation of the last 20 PELD performed by the authors is presented. Patients were distributed in 2 groups. Six (1F, 5M) patients were submitted to IL-PELD and 14 (6F, 8M) to TF-PELD. Fluoroscopy reports were obtained from patients' records, all performed with the same C-Arm device and software mode. Groups were compared using unpaired t-test. Results The IL group showed an average radiation exposure of 8.37 +/- 4.21 mGy and duration of 11.1 +/- 5.45 seconds, while the TF group showed an average radiation exposure of 28.92 +/- 7.56 mGy and duration of 42 +/- 16.64 seconds. The p-value for radiation was 0.0000036, and for time it was 0.00027. Conclusions Interlaminar PELD requires a lower radiation dose and a shorter amount of exposure than TF-PELD. Studies that concern radiation required for minimally-invasive spine surgeries should consider the PELD approaches separately.