A 5-Year Retrospective Analysis of Exposure to Ionizing Radiation by Neurosurgery Residents in the Modern Era

BACKGROUND: The potential for radiation exposure during neurosurgical training has increased dramatically in the last decade. Incorporation of instrumented and minimally invasive spinal surgery and neuroendovascular procedures into the curriculum has led to increased potential for exposure to ionizing radiation. Contemporary neurosurgery residents' exposure to radiation has not been previously reported. OBJECTIVE: To determine neurosurgery residents' exposure to radiation over the course of 7 years of training. METHODS: Retrospective analysis of a prospectively maintained radiation database from July 2009 to July 2014 for all neurosurgery residents based on radiation dosimetry data. Standard radiation safety precautions were used (e.g., lead gowns or aprons), although compliance was not specifically monitored. RESULTS: Thirty-eight neurosurgery residents were monitored from 2009 to 2014. Radiation exposure data were available for 34 residents for the final analysis. A total of 20,541 days of radiation monitoring data were available. The mean deep dose equivalent over this period was 0.67 +/- 0.75 mrem per resident/day. The calculated maximum cumulative exposure during the course of residency training was 12.15 +/- 13.50 mSv, approximately equivalent to 6 computed tomography head scans. CONCLUSIONS: To our knowledge, this study is the first to quantify radiation exposure for neurosurgery residents in the current era of training. From this work, efforts may be initiated to increase awareness and safety with regard to radiation exposure. Although the total dose is not high, a better understanding of the impact of radiation exposure on practitioners may help to drive institutional policies to reduce occupational exposure.