A New Shielding Curtain for Protection of Intraoperative Radiation During Minimally Invasive Spine Surgery

Park, Se Hoon; Ko, Myeong Jin; Park, Yong Sook; Yun, Jaehan; Byun, Hongsik

doi:10.14245/ns.1938282.141

Cited by 6 publications

(7 citation statements)

References 19 publications

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“…The use of Curtain showed the best RPE at the gonad level (90.34%) but the lowest RPE at the eye and thyroid levels (3.38% and 3.12%, respectively). These findings suggest that Curtain is specialized only in gonad protection, which is in accordance with the findings of previous studies (16)(17)(18). Because physicians are exposed to radiation throughout their bodies during interventional procedures, an average RPE of Curtain of 32.28% is not efficient compared with that of other single-protection methods.…”

Section: Discussionsupporting

confidence: 90%

Radiation-Shielding Devices: The Best Combination for Spine Interventional Procedures

Park

Kwon

et al. 2022

Journal of Vascular and Interventional Radiology

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Purpose: Although many studies have examined the efficiency of various protective devices for reducing the dose of radiation exposure to physicians during interventional pain procedures, no study has compared the protective effect of these devices when they are used in combination. The purpose of this prospective experimental study was to determine the best combination of radiation-shielding devices.Materials and Methods: Using anthropomorphic phantoms of a physician and patient, we measured the radiation protection efficiency (RPE) of each of the following protection methods and in combination during C-arm-guided simulated lumbar epidural injection: (a) personal protective equipment (PPE), (b) bedside curtain shield (Curtain), (c) x-ray tube filter (Filter), and (d) fluoroscopic collimation method (Collimation). We measured exposure doses using personal electronic dosimeters at the eye, thyroid, and gonad levels for 1 minute. Each experiment was repeated 15 times. Results:The radiation exposure dose and RPE with the best single-, double-, and triple-protection methods were as follows: PPE for the single-protection method (11.82 μSv/min, 80.04%), PPE + Collimation for the double-combination method (4.68 μSv/min, 92.09%), and PPE + Collimation + Curtain for the triple-combination method (3.08 μSv/min, 93.39%). Additionally, PPE + Collimation + Curtain + Filter for the quadruple-combination method resulted in a radiation exposure and RPE of 2.91 μSv/min and 93.61%, respectively, compared with nonprotection. Conclusions:The best single-, double-, and triple-protection method was PPE, PPE + Collimation, and PPE + Collimation + Curtain, respectively. While preparing protective equipment, we recommend prioritizing equipment in this order.

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Section: Discussionsupporting

confidence: 90%

Radiation-Shielding Devices: The Best Combination for Spine Interventional Procedures

Park

Kwon

et al. 2022

Journal of Vascular and Interventional Radiology

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“…There are published reports of radiation shielding in angiography and orthopedic surgery. [19][20][21][22] In our previous study, Inoue et al previously reported the benefit of lead curtains during URS. 7 They hand-made an operative table curtain made from lead and used it to protect against scattered radiation exposure.…”

Section: Discussionmentioning

confidence: 78%

“…Studies to reduce radiation exposure to health care workers have been previously reported. There are published reports of radiation shielding in angiography and orthopedic surgery 19–22 . In our previous study, Inoue et al .…”

Section: Discussionmentioning

confidence: 87%

Efficiency of novel shielding curtains combined with pulsed irradiation for reducing radiation exposure in an operating room: Human renal collecting system phantom study

Kaku

Inoue

Charlie³

et al. 2022

Int J of Urology

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To evaluate the impact of novel shielding curtains combined with pulsed irradiation mode to protect medical radiation workers from radiation exposure during ureteroscopy. Methods: 0.25 mm Pb equivalent novel shielding curtains were mounted to the caudal and bilateral sides of the operating table in the ureteroscopy setting. C-arm was positioned as per normal in the operating room with the X-ray tube under the patient table . A water-filled anthropomorphic renal collecting system phantom was positioned in the standard position on the operating table that was set at a height of 100 cm. The ionization chambers were also positioned at a height of 100 cm and set in eight positions. We took measurements at distances of 50, 100, 150, and 200 cm from the phantom with the focus directed toward the X-ray tube. We measured the spatial distribution of the scattered radiation dose in four combinations: (1) continuous irradiation mode without novel shielding curtains; (2) pulsed irradiation mode (11 films per second) without novel shielding curtains; (3) continuous irradiation mode with novel shielding curtains; and (4) pulsed irradiation mode with novel shielding curtains. Continuous or pulsed irradiation was activated for 30 s each time.Results: Pulsed irradiation mode with novel shielding curtains was a significantly more efficient method than other combinations to reduce scattered radiation exposure in this study (P < 0.001). There was approximately a 95% reduction in scattered radiation exposure with the pulsed irradiation mode with novel shielding curtains set up as compared with continuous irradiation mode without novel shielding curtains. Conclusion: Combining a novel shielding curtain and using a low pulse radiation setting can greatly reduce radiation exposure during ureteroscopic procedures.

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“…The protection of operators from radiation exposure and avoidance of iatrogenic radiationinduced injuries are high priorities in the introduction of new operative techniques. 14 Various recommendations for different combinations of radiation-shielding devices have been proposed. 15 However, these shielding devices are usually very heavy, and strenuous for surgeons to wear for long periods.…”

Section: Introductionmentioning

confidence: 99%

“…The radiation dose of the operator was highest in C‐arm‐guided minimally invasive spine surgery. The protection of operators from radiation exposure and avoidance of iatrogenic radiation‐induced injuries are high priorities in the introduction of new operative techniques 14 . Various recommendations for different combinations of radiation‐shielding devices have been proposed 15 .…”

Section: Introductionmentioning

confidence: 99%

Unilateral Percutaneous Kyphoplasty Using a Novel Guide Device for Thoracolumbar Osteoporotic Vertebral Fracture

Wang

Zhu

et al. 2023

Orthopaedic Surgery

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Objectives: Unilateral percutaneous kyphoplasty (UPKP) has been effective in reducing the operative time, cement volume, and cement leakage (CL) rate compared with bilateral kyphoplasty. However, no device can help to determine the trajectory during operation, especially the inner inclination angle. To assess the safety and efficacy of a novel guide device (GD) for UPKP in the treatment of thoracolumbar osteoporotic vertebral fractures (TLOVFs).Methods: From January 2019 to May 2021, 31 patients diagnosed with single TLOVF who underwent UPKP were retrospectively reviewed. The patients were divided into two groups: traditional UPKP (UPKP group, 15 patients) and UPKP assisted with GD (UPKP-GD group, 16 patients). Pre-procedure demographic, clinical and radiologic characteristics, operative procedure details, and clinical and radiologic outcomes at 1 day and 12 months post-procedure were collected. Statistical analyses were carried out using SPSS 24.0. The baseline characteristics of the two groups were compared by the independent sample t test or the χ 2 test. The anterior height or local kyphotic angle (LKA) of the fractured vertebrae, visual analog scale (VAS) score, and Oswestry Disability Index (ODI) within groups were compared using the paired t test.Results: A total of 31 patients (five men and 26 women; age range: 58-90 years) completed the full 12-month postoperative follow-up schedule. No significant differences were observed between treatment groups with respect to sex, age, body mass index, preoperative bone mineral density, or surgical level. Compared with the UPKP group, the operation time in the UPKP-GD group was significantly shorter (40.8 AE 5.5 min vs. 48.5 AE 8.5 min, p = 0.005), and the number of intraoperative fluoroscopy times in the UPKP-GD group was significantly decreased (20.6 AE 4.5 vs. 25.2 AE 2.4, p = 0.001). Five (31.3%) patients in the UPKP-GD group and four (26.7%) patients in the UPKP group had bone CL. The VAS and ODI scores, anterior height and LKA of the fractured vertebrae were significantly improved after surgery in each group. No significant differences in postoperative VAS and ODI scores, anterior height or LKA of the fractured vertebrae, volume of injected cement or CL were observed between the two groups. Conclusion:Unilateral puncture using a novel GD is a safe and effective technique for patients with TLFs and UPKP assisted with a novel GD is associated with fewer intraoperative fluoroscopy times and shorter operation time.

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A New Shielding Curtain for Protection of Intraoperative Radiation During Minimally Invasive Spine Surgery

Cited by 6 publications

References 19 publications

Radiation-Shielding Devices: The Best Combination for Spine Interventional Procedures

Radiation-Shielding Devices: The Best Combination for Spine Interventional Procedures

Efficiency of novel shielding curtains combined with pulsed irradiation for reducing radiation exposure in an operating room: Human renal collecting system phantom study

Unilateral Percutaneous Kyphoplasty Using a Novel Guide Device for Thoracolumbar Osteoporotic Vertebral Fracture

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