Patient Exposure and Associated Radiation Risks from Fluoroscopically Guided Vertebroplasty or Kyphoplasty

Abstract

Patient radiation exposure and associated risks from vertebroplasty or kyphoplasty may be considerable. Data obtained in the current study may be used to establish patient effective dose, gonadal dose, and entrance skin exposure, as well as associated risks, from these fluoroscopically guided surgical treatments of spinal disorders.

Fluoroscopic radiation exposure of the kyphoplasty patient

“…3), the comparable ET values between the case groups (Table 2) allow a reasonable assumption of a comparable range of patient doses between the groups. Our mean E values are found to compare favourably with those of Perisinakis et al [12], which averaged 8.5-12.7 mSv, in dependence of the treated region, in 11 patients with an average total ET of 10.1 min.…”

“…This may reflect the greater technical demand of KP over VP during tool introduction and balloon inflation. In the only other dosimetrical investigation of patient exposure in KP by Perisinakis et al [12], the average total ET was 10.1 min (4.7 min ET ap and 5.4 min ET lat ) in 11 patients. Although not clearly stated by these authors, their procedures appear to have been conducted with a single fluoroscopy unit.…”

“…The mean value for E tot (4.28 mSv), as reported in Table 3, is lower than E-values resulting from common, not specially dose reduced CT-examinations of the whole abdomen, with only the maximum value (10.14 mSv) equalling the typical mean value for abdominal CT [3]. According to the review by Perisinakis et al [12], our mean KP patient dose of 4.28 mSv is well within the range of other common interventional fluoroscopic procedures such as radiofrequency catheter cardiac ablation (5.7 mSv), endoscopic retrograde cholangiopancreatography (12.4 mSv) and enteroclysis (14.0 mSv).…”

Fluoroscopy for transpedicular screw placement in scoliosis: to what extent can radiation exposure be reduced by the freehand technique?

“…Thermoluminescent dosimeters were not used, and separate DAP values for AP and lateral views, or for thoracic and lumbar regions could not be measured separately. However, the effective dose to which the patient was exposed would be as low as 0.27 msv even in the worst possible case scenario (when the maximum DAP to Effective dose conversion coefficient with AP view in L1 vertebrae level was used ) (12).…”

“…In spinal surgery, high doses of ionizing radiation are delivered during surgical procedures that require fluoroscopic control, such as correction of spinal deformities with third generation transpedicular screws or kyphoplasty (12,17). Therefore, radiation safety has become a major concern for spinal surgeons in recent years.…”