Surgeon's and Patient's Radiation Exposure Through Vertebral Body Cement Augmentation Procedures: A Prospective Multicentric Study of 49 Cases

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• 作者：Nicolas Lonjon¹ ; ^{nlonjon@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Marine Le Corre¹ ; Julien Le Roy² ; Joë ; l Greffier³ ; St&eacute ; phane Fuentes⁴ ; J&eacute ; rô ; me Tonetti⁵ ; Yann Philippe Charles⁶ ; Benjamin Blondel⁷ ; Pascal Kouyoumdjï ; an⁸
• 关键词：Fluoroscopy ; Fracture ; Radiation exposure ; Spine surgeon ; Vertebral body augmentation
• 刊名：World Neurosurgery
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：93
• 期：Complete
• 页码：371-376
• 全文大小：1481 K

文摘

Vertebral body cement augmentation as a treatment option for osteoporotic or traumatic fractures has become increasingly popular during the past decade. However, these surgical procedures require numerous fluoroscopic examinations, resulting in high radiation exposure for the patient and the surgical team. The aim of this study was to evaluate the level of radiation exposure of the spine surgeon and the patient during these percutaneous procedures.

Methods

Forty-nine patients admitted for single- or 2-level vertebral compression fracture were prospectively included and treated with vertebral body cement augmentation. For each procedure, radiation dose was measured on the surgeon's whole body, lens, and extremities as well as patient irradiation. Each surgeon wore 2 thermoluminescent dosimeters to measure lens and extremities radiation exposure and 1 electronic personal dosimeter. Patient clinical and surgical data, effective dose to patient, and surgeon were analyzed.

Results

Mean operative time was 31.5 ± 11.7 minutes. The average fluoroscopic time was 61.0 ± 27.1 seconds. The average whole-body radiation dose per procedure was 1.4 ± 2.1 μSv. The average equivalent dose to lens and extremities were 44 μSv and 59 μSv, respectively.

Conclusions

Values of radiation doses for surgeon and patient were lower than those reported in the previous literature. The recommended annual dose limit is set to 500 mSv for extremities and 150 mSv for lens. According to our results, the exposure dose to the eye exceeds the annual limit after 3500 procedures. However, there is increasing concern among surgeons about radiation exposure, and there is still a need for solutions as preventive measures.