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Diagnostic radiation exposure in children with spinal dysraphism: an estimation of the cumulative effective dose in a cohort of 135 children from The Netherlands
  1. Jasper van Aalst1,
  2. Cécile R L P N Jeukens2,
  3. Johan S H Vles3,
  4. Emiel A van Maren1,
  5. Alfons G H Kessels4,
  6. Dan L H M Soudant3,
  7. Jacobiene W Weber3,
  8. Alida A Postma2,
  9. Erwin M J Cornips1
  1. 1Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, The Netherlands
  2. 2Department of Radiology, Maastricht University Medical Centre, Maastricht, The Netherlands
  3. 3Department of Child Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
  4. 4Department of Clinical Epidemiology and Medical Technical Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
  1. Correspondence to Dr J van Aalst, Department of Neurosurgery, Maastricht University Medical Centre, Oxfordlaan 10, Maastricht 6229 EV, The Netherlands; j.van.aalst{at}


Objective Based on the assumption that children with spinal dysraphism are exposed to a large amount of ionising radiation for diagnostic purposes, our objective was to estimate this exposure, expressed in cumulative effective dose.

Design Retrospective cohort study.

Settings The Netherlands.

Patients 135 patients with spinal dysraphism and under 18 years of age treated at our institution between 1991 and 2010.

Results A total of 5874 radiological procedures were assessed of which 2916 (49.6%) involved ionising radiation. Mean cumulative effective dose of a child with spinal dysraphism during childhood was 23 mSv, while the individual cumulative effective dose ranged from 0.1 to 103 mSv. Although direct radiography accounted for 81.7% of examinations, the largest contributors to the cumulative effective dose were fluoroscopic examinations (40.4% of total cumulative effective dose).

Conclusions Exposure to ionising radiation and associated cancer risk were lower than expected. Nevertheless, the use of ionising radiation should always be justified and the medical benefits should outweigh the risk of health detriment, especially in children.

  • Neurology
  • Imaging
  • Neurosurgery
  • Multidisciplinary team-care
  • Oncology

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