Evaluation of Operator Radioprotection Using a New Injection Device during Vertebroplasty

Abstract

<jats:p> This study aimed to evaluate the protection granted by a simple device (X'TENS®, Thiebaud, France) and to provide operators with information on the performance of this new device, which has not yet been assessed. Our assumption is that this device efficiently reduces the radiation dose to the operator. </jats:p><jats:p> In a prospective clinical study, the radiation dose the operator's hand receives has been assessed using a specific sensor (UNFOR Instrument). Each patient included in the study was to receive at least two injections of cement during the procedure. Exposure was measured with and without the range extender. The data collected were then processed using a Wilcoxon matched pairs test. </jats:p><jats:p> During 14 interventions, 20 vertebrae were treated with both procedures. Eleven women and three men were included. Seven patients underwent vertebroplasty for metastatic lesions and seven for osteoporotic lesions, bone fractures or vertebral compressions. The average injection time was 1.35 minutes with the device and 1.20 without (p=0.75). The dose to the hand per ml injected was 111.37 vs. 166.91 (p&lt;0.05). </jats:p><jats:p> Theoretically, the protection granted by the range extender depends on the length of the device. Our results are consistent with the inverse-square law. However, the variations in our results indicate that a proper and rigorous use is mandatory for the device to be effective. Given that radioprotection during fluoroscopy procedures is a frequently raised issue, the need for information for a safer practice increases likewise. </jats:p>

The Great Unknown—A systematic literature review about risk associated with intraoperative imaging during orthopaedic surgeries

“…In the next step, only studies where effective radiation to the surgeon was directly measured in the operating theatre were further considered for this review. Studies using indirect measurements or formulas to back calculate surgeon exposure [14][15][16][17][18][19][20][21][22][23][24] as well as studies measuring radiation exposure in Gray only were not further reviewed because of the problem of comparability [25][26][27][28][29][30][31].…”

Significantly reduced radiation dose to operators during percutaneous vertebroplasty using a new cement delivery device

“…In reality, most of the radiation dose received by the operators is consecutive to cement injection under continuous fluoroscopy. Nguyen-Kim Let al [ 10 ] reported an new injection device which is made up of a 30 cm long metallic tube in which the cement flows, propelled by a metallic mandrel. This mandrel is set with a handle which allows the user a firm grip to achieve high-pressure injection.…”