Use of a radiopaque localizer grid to reduce radiation exposure

The radiopaque localizer grid was utilized to plan the point of entry for minimally invasive spine surgery. Use of the grid allowed the surgeon to accurately pinpoint the ideal entry point for the procedure with just one or two fluoroscopic X-ray images.The reusable localizer grid is a simple and practical device that may be utilized to more efficiently plan an entry site on the skin, thus reducing radiation exposure. This device or a modified version may be utilized for any procedure involving the spine.Decreased soft tissue trauma and quicker patient recovery time have garnered wider support and popularity for minimally invasive spine surgery [1]. Demarcating the ideal entry point on the skin is a critical step for the success of the minimally invasive procedure. A suboptimal entry point leads to inadequate exposure of the surgical site. This is associated with increased operative time, complications or possible inability to perform the procedure [1-6].Traditional methods using radiopaque markers such as K-wires, or surgical instruments such as towel clamps require numerous radiographic images in a trial-and-error fashion. Radiopaque markers are placed on a patient's back at the surgeon's discretion and fluoroscopic antero-posterior (AP) X-ray images are obtained. These markers, depending on their location in relation to the desired target on the spine, would then be rearranged. Additional images are obtained until the surgeon is able to mark out the ideal entry site on the patient's back for that particular procedure. K- wires could move during these steps, necessitating even more images. However, additional use of fluoroscopic X-ray images during localization results in increased radiation exposure to both patients and surgical staff [7-10].While radiation exposure and risk to spine surgeons and medical personnel have not been adequately documented, an increased incidence of thyroid cancer among orthopedic surgeons has been noted [10]. Spine surgeons are especia