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

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Percutaneous vertebroplasy (PVP) might lead to significant radiation exposure to patients, operators, and operating room personnel. Therefore, radiaton exposure is a concern. The aim of this study was to present a remote control cement delivery device and study whether it can reduce dose exposue to operators.

Methods

After meticulous preoperative preparation, a series of 40 osteoporosis patients were treated with unilateral approach PVP using the new cement delivery divice. We compared levels of fluoroscopic exposure to operator standing on different places during operation. group A: operator stood about 4 meters away from X-ray tube behind the lead sheet. group B: operator stood adjacent to patient as using conventional manual cement delivery device.

Results

During whole operation process, radiation dose to the operator (group A) was 0.10 ± 0.03 (0.07-0.15) μSv, group B was 12.09 ± 4.67 (10–20) μSv. a difference that was found to be statistically significant (P < 0.001) between group A and group B.

Conclusion

New cement delivery device plus meticulous preoperative preparation can significantly decrease radiation dose to operators.

Related collections

Most cited references 11

Record: found
Abstract: found
Article: not found

Percutaneous transpedicular vertebroplasty with PMMA: operative technique and early results. A prospective study for the treatment of osteoporotic compression fractures.

U Berlemann, P Heini, B Wälchli (2000)

Vertebroplasty-percutaneous cement augmentation of osteoporotic vertebrae is an efficient procedure for the treatment of painful vertebral fractures. From a prospectively monitored series of 70 patients with 193 augmented vertebrae for osteoporotic and metastatic lesions, we analysed a group of 17 patients suffering from back pain due to osteoporotic fractures. The reinforcement of 45 vertebral bodies in these patients led to a significant and lasting pain reduction (P < 0.01 ). The presented technique is useful, as, in one session, at least four injections can be performed when required, allowing the prophylactic reinforcement of adjacent vertebrae as well. The use of a low-viscosity polymethyl methacrylate (PMMA) in combination with a non-ionic liquid contrast dye provides a reliable and safe procedure. Extraosseous cement leakage was seen in 20% of the interventions; however, none of them had clinical sequelae.

0 comments Cited 28 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Radiation exposure to the surgeon and the patient during kyphoplasty.

Isador Lieberman, Takayuki Yamashita, Thomas Mroz … (2008)

Prospective study of patients who underwent single or multilevel kyphoplasty for vertebral fractures. To quantify the radiation exposure to the surgeon and to the patient during kyphoplasty, and also to provide a procedural algorithm that effectively minimizes the radiation exposure to the surgeon during any fluoroscopic-guided procedure. Spine surgeons who perform minimally invasive procedures often employ fluoroscopy for intraoperative navigation. Twenty-seven patients were enrolled. Two fluoroscopes (1 anterior/posterior and 1 lateral) were used for localization, navigation, and monitoring cement flow. All surgeons wore thyroid shields and lead aprons. The dose of radiation exposure was measured by dosimeter badges. One badge was attached to each patient. The surgeons wore 3 badges: under the thyroid shield (protected), under the lead apron over the left chest (protected), and outside the lead apron over the left chest (unprotected). A thermoluminescent ring dosimeter was worn on the right hand for 18 cases, and on the left hand for 9 cases. The exposure time was 5.7+/-2.0 minutes/vertebra for a single level (n=10), 3.9+/-0.8 minutes/vertebra for a 2 level (n=9), 2.9+/-1.2 minutes/vertebra for a 3 level kypholasty (n=8). The exposure time of single level kyphoplasy was significantly different from that of multilevel kyphoplasy (2 level, P=0.040; 3 level, P=0.002). Surgeon exposure as measured by the protected dosimeter was less than the minimum reportable dose (<0.010 mSv). Exposure as measured by the unprotected dosimeter, which is equivalent to deep whole body exposure was 0.248+/-0.170 mSv/vertebra. The eye exposure was 0.271+/-0.200 mSv/vertebra, and the shallow exposure (hand/skin) was 0.273+/-0.200 mSv/vertebra. The hand exposure was 1.744+/-1.173 mSv/vertebra. Without eye or hand protection, the total radiation exposure dose to these areas would exceed the occupational exposure limit after 300 cases per year. Surgeons should wear lead lined glasses and keep their hands out of the radiation beam.

0 comments Cited 16 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Radiation exposure to the surgeon during fluoroscopically assisted percutaneous vertebroplasty: a prospective study.

P Heini, Rene Orler, R. Mini … (2005)

A prospective case control study design was conducted. The purpose of the current study was to determine the intraoperative radiation hazard to spine surgeons by occupational radiation exposure during percutaneous vertebroplasty and possible consequences with respect to radiation protection. The development of minimally invasive surgery techniques has led to an increasing number of fluoroscopically guided procedures being done percutaneously such as vertebroplasty, which is the percutaneous cement augmentation of vertebral bodies. Three months of occupational dose data for two spine surgeons was evaluated measuring the radiation doses to the thyroid gland, the upper extremities, and the eyes during vertebroplasty. The annual risk of developing a fatal cancer of the thyroid is 0.0025%, which means a very small to small risk. The annual morbidity (the risk of developing a cancer including nonfatal ones) is 0.025%, which already means a small to medium risk. The dose for the eye lens was about 8% of the threshold dose to develop a radiation induced cataract (150 mSv); therefore, the risk is very low but not negligible. The doses measured for the skin are 10% of the annual effective dose limit (500 mSv) recommended by the ICRP (International Commission on Radiologic Protection); therefore, the annual risk for developing a fatal skin cancer is very low. While performing percutaneous vertebroplasty, the surgeon is exposed to a significant amount of radiation. Proper surgical technique and shielding devices to decrease potentially high morbidity are mandatory. Training in radiation protection should be an integral part of the education for all surgeons using minimally invasive radiologic-guided interventional techniques.

0 comments Cited 14 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Guang-Quan Zhang

Yan-Zheng Gao

Shu-Lian Chen

Shuai Ding

Kun Gao

Journal

Journal ID (nlm-ta): BMC Musculoskelet Disord

Journal ID (iso-abbrev): BMC Musculoskelet Disord

Title: BMC Musculoskeletal Disorders

Publisher: BioMed Central

ISSN (Electronic): 1471-2474

Publication date Collection: 2014

Publication date (Electronic): 1 August 2014

Volume: 15

Page: 260

Affiliations

[1 ]Orthopedic of henan provincial people’s hospital(Zhengzhou university people’s hospital), Weiwu road 7, Zhengzhou city, henan province 450003, China

Article

Publisher ID: 1471-2474-15-260

DOI: 10.1186/1471-2474-15-260

PMC ID: 4236675

PubMed ID: 25084860

SO-VID: 7213c954-4263-4bab-babb-623337a78a15

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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

Read this article at

Abstract

Background

Methods

Results

Conclusion

Related collections

Orthopedics

Most cited references 11

Percutaneous transpedicular vertebroplasty with PMMA: operative technique and early results. A prospective study for the treatment of osteoporotic compression fractures.

Radiation exposure to the surgeon and the patient during kyphoplasty.

Radiation exposure to the surgeon during fluoroscopically assisted percutaneous vertebroplasty: a prospective study.

Author and article information

Contributors

Journal

Affiliations

Article

History

Categories

Comments

Comment on this article

Similar content 271

Cited by 2

Most referenced authors 56