Evaluation of Radiation Exposure from X-ray Imaging Among Scoliotic Patients at a Tertiary Care Hospital

Abstract

Objectives: The radiographs were reported to cause a potential risk of cancer resulting from multiple spinal radiographs’ cumulative radiation. Based on the spine’s anatomic location, covering a large body area and its proximity to radiosensitive organs, the radiation dose required is relatively higher than annual background radiation ~2.4 millisievert (mSv)/year. The aim of the study was to estimate the radiation doses from imaging in scoliotic patients at a tertiary care hospital. Methods: The study design was a retrospective cohort study where the charts of scoliotic patients aged 12 years and older were reviewed between 2008 and 2017. Evaluation of the spinal imaging was commenced at the time of diagnosis, where the patients were initially seen in the orthopedic clinic with a follow-up period of 2 years. The estimated radiation dose was measured according to the average effective dose by mSv. Results: The total sample size was 140 patients, and the mean age was 19.3 years. Idiopathic scoliosis was the main subtype with 116 patients (82.6%). The average of total spine X-ray films was 5.2. The average cumulative effective radiation dose was estimated at 22.13 mSv. The initial management type was found to have a significant linear effect (P < 0.0001) on the cumulative effective radiation dose. Conclusions: The cumulative radiation dose is markedly elevated in comparison to the reported numbers in the literature (yearly average dose = 2.17–15.07 mSv). Ultra-low-dose radiation may need to be used instead of standard radiographs to reduce radiation risk.