Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2013

Open Access 01-12-2013 | Research article

Comparing radiation exposure during percutaneous vertebroplasty using one- vs. two-fluoroscopic technique

Authors: Yen-Yao Li, Tsung-Jen Huang, Chin-Chang Cheng, Meng-Huang Wu, Ching-Yu Lee

Published in: BMC Musculoskeletal Disorders | Issue 1/2013

Login to get access

Abstract

Background

Percutaneous vertebroplasty (PV) requires relatively lengthy fluoroscopic guidance, which might lead to substantial radiation exposure to patients or operators. The two-fluoroscopic technique (two-plane radiographs obtained using two fluoroscopes) during PV can provide simultaneous two-planar projections with reducing operative time. However, the two-fluoroscopic technique may expose the operator or patient to increased radiation dose. The aim of this study was to quantify the amount of radiation exposure to the patient or operator that occurs during PV using one- vs. two-fluoroscopic technique.

Methods

Two radiation dosimeters were placed on the right flank of each patient and on the upper sternum of each operator during 26 single-level PV procedures by one senior surgeon. The use of two-fluoroscopic technique (13 patients) and one-fluoroscopic technique (13 patients) were allocated in a consecutive and alternative manner. The operative time and mean radiation dose to each patient and operator were monitored and compared between groups.

Results

Mean radiation dose to the patient was 1.97 ± 1.20 mSv (95% CI, 0.71 to 3.23) for the one-fluoroscopic technique group vs. 0.95 ± 0.34 mSv (95% CI, 0.85 to 1.23) for the two-fluoroscopic technique group (P =0.031). Mean radiation dose to the operator was 0.27 ± 0.12 mSv (95% CI, 0.17–0.56) for the one-fluoroscopic technique group vs. 0.25 ± 0.14 mSv (95% CI, 0.06–0.44) for the two-fluoroscopic technique group (P = 0.653). The operative time was significantly different between groups: 47.15 ± 13.48 min (range, 20–75) for the one-fluoroscopic technique group vs. 36.62 ± 8.42 min (range, 21–50) for the two-fluoroscopic technique group (P =0.019).

Conclusion

Compared to the one-fluoroscopic technique, the two-fluoroscopic technique used during PV provides not only shorter operative times but also reduces the radiation exposure to the patient. There was no significant difference between the two techniques with regards to radiation exposure to the operator.
Appendix
Available only for authorised users
Literature
1.
go back to reference Gangi A, Guth S, Imbert JP, Marin H, Dietemann JL: Percutaneous vertebroplasty: indications, technique, and results. Radiographics. 2003, 23: e10-10.1148/rg.e10.CrossRefPubMed Gangi A, Guth S, Imbert JP, Marin H, Dietemann JL: Percutaneous vertebroplasty: indications, technique, and results. Radiographics. 2003, 23: e10-10.1148/rg.e10.CrossRefPubMed
2.
go back to reference Peh WCG, Gilula LA: Percutaneous vertebroplasty: an update. Seminar in Ultrasound, CT and MRI. 2005, 52-64. Peh WCG, Gilula LA: Percutaneous vertebroplasty: an update. Seminar in Ultrasound, CT and MRI. 2005, 52-64.
3.
go back to reference Mathis JM, Barr JD, Belkoff SM, Barr MS, Jensen ME, Deramond H: Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. Am J Neuroradiol. 2001, 22: 373-381.PubMed Mathis JM, Barr JD, Belkoff SM, Barr MS, Jensen ME, Deramond H: Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. Am J Neuroradiol. 2001, 22: 373-381.PubMed
4.
go back to reference Li YY, Hsu RW, Cheng CC, Huang TJ: Minimally invasive vertebroplasty managed by a two C-arm fluoroscopic technique. Minim Invasive Ther Allied Technol. 2007, 16: 350-354. 10.1080/13645700701627654.CrossRefPubMed Li YY, Hsu RW, Cheng CC, Huang TJ: Minimally invasive vertebroplasty managed by a two C-arm fluoroscopic technique. Minim Invasive Ther Allied Technol. 2007, 16: 350-354. 10.1080/13645700701627654.CrossRefPubMed
5.
go back to reference Faul F, Erdfelder E, Lang AG, Buchner A: G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007, 39 (2): 175-191. 10.3758/BF03193146.CrossRefPubMed Faul F, Erdfelder E, Lang AG, Buchner A: G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007, 39 (2): 175-191. 10.3758/BF03193146.CrossRefPubMed
6.
go back to reference Kruger R, Faciszewski T: Radiation dose reduction to medical staff during vertebroplasty - A review of techniques and methods to mitigate occupational dose. Spine. 2003, 28: 1608-1613.PubMed Kruger R, Faciszewski T: Radiation dose reduction to medical staff during vertebroplasty - A review of techniques and methods to mitigate occupational dose. Spine. 2003, 28: 1608-1613.PubMed
7.
go back to reference Kallmes DF OE, Roy SS, Piccolo RG, Marx WF, Lee JK, Jensen ME: Radiation Dose to the Operator during Vertebroplasty: Prospective Comparison of the Use of 1-cc Syringes versus an Injection Device. Am J Neuroradiol. 2003, 24: 1257-1260.PubMed Kallmes DF OE, Roy SS, Piccolo RG, Marx WF, Lee JK, Jensen ME: Radiation Dose to the Operator during Vertebroplasty: Prospective Comparison of the Use of 1-cc Syringes versus an Injection Device. Am J Neuroradiol. 2003, 24: 1257-1260.PubMed
8.
go back to reference Harstall R, Heini PF, Mini RL, Orler R: Radiation exposure to the surgeon during fluoroscopically assisted percutaneous vertebroplasty - A prospective study. Spine. 2005, 30: 1893-1898. 10.1097/01.brs.0000174121.48306.16.CrossRefPubMed Harstall R, Heini PF, Mini RL, Orler R: Radiation exposure to the surgeon during fluoroscopically assisted percutaneous vertebroplasty - A prospective study. Spine. 2005, 30: 1893-1898. 10.1097/01.brs.0000174121.48306.16.CrossRefPubMed
9.
go back to reference Komemushi A, Tanigawa N, Kariya S, Kojima H, Shomura Y, Sawada S: Radiation exposure to operators during vertebroplasty. J Vasc Interv Radiol. 2005, 16: 1327-1332. 10.1097/01.RVI.0000179794.65662.01.CrossRefPubMed Komemushi A, Tanigawa N, Kariya S, Kojima H, Shomura Y, Sawada S: Radiation exposure to operators during vertebroplasty. J Vasc Interv Radiol. 2005, 16: 1327-1332. 10.1097/01.RVI.0000179794.65662.01.CrossRefPubMed
11.
go back to reference Mroz TE, Yamashita T, Davros WJ, Lieberman IH: Radiation Exposure to the Surgeon and the Patient During Kyphoplasty. J Spinal Disord Tech. 2008, 21: 96-100. 10.1097/BSD.0b013e31805fe9e1.CrossRefPubMed Mroz TE, Yamashita T, Davros WJ, Lieberman IH: Radiation Exposure to the Surgeon and the Patient During Kyphoplasty. J Spinal Disord Tech. 2008, 21: 96-100. 10.1097/BSD.0b013e31805fe9e1.CrossRefPubMed
12.
go back to reference Wagner LK, Mulhern OR: Radiation-attenuating surgical gloves: effects of scatter and secondary electron production. Radiology. 1996, 200 (1): 45-48.CrossRefPubMed Wagner LK, Mulhern OR: Radiation-attenuating surgical gloves: effects of scatter and secondary electron production. Radiology. 1996, 200 (1): 45-48.CrossRefPubMed
13.
go back to reference Galibert P, Deramond H, Rosat P, Le Gars D: Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie. 1987, 33: 166-168.PubMed Galibert P, Deramond H, Rosat P, Le Gars D: Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie. 1987, 33: 166-168.PubMed
14.
go back to reference Li YY, Huang TJ, Cheng CC, Hsu Robert WW: A comparison between one- and two-fluoroscopic techniques in percutaneous vertebroplasty. BMC Musculoskelet Disord. 2008, 9: 67-10.1186/1471-2474-9-67.CrossRefPubMedPubMedCentral Li YY, Huang TJ, Cheng CC, Hsu Robert WW: A comparison between one- and two-fluoroscopic techniques in percutaneous vertebroplasty. BMC Musculoskelet Disord. 2008, 9: 67-10.1186/1471-2474-9-67.CrossRefPubMedPubMedCentral
15.
go back to reference Mehdizade A, Lovblad KO, Wilhelm KE, Somon T, Wetzel SG, Kelekis AD, Yilmaz H, Abdo G, Martin JB, Viera JM, Rüfenacht DA: Radiation dose in vertebroplasty. Neuroradiology. 2004, 46 (3): 243-245. 10.1007/s00234-003-1156-0.CrossRefPubMed Mehdizade A, Lovblad KO, Wilhelm KE, Somon T, Wetzel SG, Kelekis AD, Yilmaz H, Abdo G, Martin JB, Viera JM, Rüfenacht DA: Radiation dose in vertebroplasty. Neuroradiology. 2004, 46 (3): 243-245. 10.1007/s00234-003-1156-0.CrossRefPubMed
16.
go back to reference Fitousi NT, Efstathopoulos EP, Delis HB, Kottou S, Kelekis AD, Panayiotakis GS: Patient and staff dosimetry in vertebroplasty. Spine. 2006, 31 (23): E884-9-discussioin E890CrossRef Fitousi NT, Efstathopoulos EP, Delis HB, Kottou S, Kelekis AD, Panayiotakis GS: Patient and staff dosimetry in vertebroplasty. Spine. 2006, 31 (23): E884-9-discussioin E890CrossRef
17.
go back to reference Boszczyk BM, Bierschneider M, Panzer S, Panzer W, Harstall R, Schmid K, Jaksche H: Fluoroscopic radiation exposure of the kyphoplasty patient. Eur Spine J. 2006, 15: 347-355. 10.1007/s00586-005-0952-0.CrossRefPubMed Boszczyk BM, Bierschneider M, Panzer S, Panzer W, Harstall R, Schmid K, Jaksche H: Fluoroscopic radiation exposure of the kyphoplasty patient. Eur Spine J. 2006, 15: 347-355. 10.1007/s00586-005-0952-0.CrossRefPubMed
18.
go back to reference Perisinakis K, Damilakis J, Theocharopoulos N, Papadokostakis G, Hadjipavlou A, Gourtsoyiannis N: Patient exposure and associated radiation risks from fluoroscopically guided vertebroplasty or kyphoplasty. Radiology. 2004, 232: 701-770. 10.1148/radiol.2323031412.CrossRefPubMed Perisinakis K, Damilakis J, Theocharopoulos N, Papadokostakis G, Hadjipavlou A, Gourtsoyiannis N: Patient exposure and associated radiation risks from fluoroscopically guided vertebroplasty or kyphoplasty. Radiology. 2004, 232: 701-770. 10.1148/radiol.2323031412.CrossRefPubMed
19.
go back to reference Lee ST, Chen JF: A syringe compressor for vertebroplasty: technical note. Surg Neurol. 2004, 61: 580-584. 10.1016/j.surneu.2003.10.029.CrossRefPubMed Lee ST, Chen JF: A syringe compressor for vertebroplasty: technical note. Surg Neurol. 2004, 61: 580-584. 10.1016/j.surneu.2003.10.029.CrossRefPubMed
Metadata
Title
Comparing radiation exposure during percutaneous vertebroplasty using one- vs. two-fluoroscopic technique
Authors
Yen-Yao Li
Tsung-Jen Huang
Chin-Chang Cheng
Meng-Huang Wu
Ching-Yu Lee
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2013
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-14-38

Other articles of this Issue 1/2013

BMC Musculoskeletal Disorders 1/2013 Go to the issue