Assessment of Radiation Dose in Lumbar Spine Radiography at Hospitals in Sokoto State, North West Nigeria

Lumbar spine radiography is among the highest-dose conventional radiographic examinations, and establishing local dose benchmarks for this procedure in North West Nigerian hospitals is essential for applying optimisation principles and identifying outliers requiring dose reduction. This study measures radiation entrance surface doses for lumbar spine radiography across hospitals in Sokoto State and compares findings against established diagnostic reference levels. A prospective dose measurement study is conducted across six hospitals in Sokoto metropolis, documenting entrance surface air kerma for anteroposterior and lateral lumbar spine projections in adult patients using thermoluminescent dosimeters placed at the defined reference point. Concurrent recording of exposure parameters and patient size indices enables dose determinant analysis. Descriptive statistics and comparison against IAEA and European Commission reference levels are performed in SPSS. Available lumbar spine dosimetry literature from North West Nigeria identifies significantly higher lateral projection doses compared to anteroposterior views, and a wide inter-hospital dose range attributable to technique chart variability and absence of automatic exposure control use. The IAEA Safety Reports Series No. 40 and EC Radiation Protection publication 109 DRL frameworks provide the comparative normative standards. Findings are expected to reveal mean doses exceeding European diagnostic reference levels for the lateral projection in most assessed facilities. Recommendations address hospital-specific lumbar spine technique optimisation, implementation of automatic exposure control where available, and a state-level dose audit programme for Sokoto State hospitals. Keywords: lumbar spine radiography, entrance surface dose, diagnostic reference levels, Sokoto State, North West Nigeria.