Operator Radiation Dose in C-Arm Fluoroscopy: A Narrative Review of Region- and Procedure-Specific Evidence and a Practical Framework for Intraoperative Dose Estimation

Background and Objectives: C-arm fluoroscopy is used across virtually every anatomical region and target disease in orthopaedic, spinal, and interventional practice, yet the operator’s own radiation burden is rarely quantified at the point of care. Published dose data are fragmented across procedure-specific studies using incompatible dosimetric quantities, making it difficult for a surgeon to answer this simple question: how much radiation am I receiving during this case, and how many such cases are safe? This narrative review synthesises the available evidence into a region- and procedure-indexed reference, and derives a transparent arithmetic framework that allows an operator to estimate personal dose from quantities displayed on the C-arm console. Materials and Methods: We searched PubMed/MEDLINE, Scopus, and Google Scholar for English-language studies published between January 1990 and May 2026 reporting operator or patient radiation dose during mobile C-arm or mini C-arm fluoroscopy in musculoskeletal, spinal, and fluoroscopically guided pain procedures. Priority was given to open-access primary dosimetry studies, phantom experiments with explicit geometry, systematic reviews, and international radiological protection guidance. Reported quantities were harmonised to SI units and, where possible, converted to a common basis using published dose conversion coefficients.