Occupational radiation exposure in spine surgery: organ-specific OSL phantom dosimetry and workload-based risk assessment.

Occupational radiation exposure during fluoroscopy-guided dorsolumbar spine surgery was evaluated using ATOM phantoms and carbon-doped aluminium oxide () nanoDot optically stimulated luminescence (OSL) dosemeters. A controlled 50-acquisition protocol (comprising anteroposterior, oblique, and lateral projections) was used to map organ-specific doses for an operating surgeon at 50 cm from the C-arm isocentre. The expanded measurement uncertainty was 7.6% (). In the unprotected configuration, the highest equivalent doses occurred in the thoracic region, specifically the breasts (0.0430 mSv/procedure), oesophagus (0.0335 mSv/procedure), lungs (0.0230 mSv/procedure), and stomach (0.0280 mSv/procedure). Standard protective equipment (0.5 mm Pb-equivalent) reduced these organ doses by 27.3%-42.9%. However, these reduction factors characterise the complete geometric setup rather than the intrinsic attenuation of individual shielding devices. Based on International Commission on Radiological Protection Publication 103 tissue-weighting factors, the calculated effective dose was 0.152 mSv per simulated procedure. Illustrative workload extrapolations () yielded cumulative annual effective doses of 14.58 mSv yrfor 96 procedures and 36.45 mSv yrfor 240 procedures. These scenario-based projections are highly specific to the evaluated setup, table height, and acquisition parameters. The findings support the utility of local kerma-area product-normalised dose audits, rigorous individual monitoring, and the consideration of conditional Category A classification for high-volume spine surgeons where comparable exposures are verified by local clinical practice.