Literature DB >> 11994810

Radiation exposure of the spinal interventionalist performing fluoroscopically guided lumbar transforaminal epidural steroid injections.

Kenneth P Botwin1, Santhosh Thomas, Robert D Gruber, Francisco M Torres, Constantine C Bouchlas, Joshua J Rittenberg, Sanjiv Rao.   

Abstract

OBJECTIVE: To evaluate radiation exposure to spinal interventionalists while performing transforaminal epidural steroid injections (TFESIs).
DESIGN: Prospective study.
SETTING: Multidisciplinary spine center. PARTICIPANTS: One hundred consecutive patients with either herniated nucleus pulposus (HNP) or lumbar spinal stenosis (LSS). INTERVENTION: Fluroscopically guided lumbar TFESIs. MAIN OUTCOME MEASURE: Radiation exposure was monitored by radiography technologists who allocated 4 dosimetry badges to all spinal interventionalists performing fluroscopically guided lumbar TFESIs on patients being treated for radicular pain. Badges were placed on the ring finger, glasses, and the inside and outside of the lead apron worn by the interventionalists. The radiography technologists also wore marked badges outside their lead aprons. One control badge was placed 67in away from the fluoroscopy table and a second badge was placed in a desk more than 500ft away from the procedure to monitor ambient radiation.
RESULTS: The average fluoroscopy time per procedure was 15.16 seconds. The average exposure per procedure was 0.7mrem at the ring badge, 0.4mrem at the glasses badge, and 0.3mrem at the outside apron badge. No radiation was detectable at the inside apron or at the outside room control badge. The cumulative exposure to the interventionalists from all 100 procedures was 70mrem at the ring badge, 40mrem at the glasses badge, and 30mrem at the outside apron badge. The radiography technologists' average exposure during these procedures was below the limit of detectablility. Radiation time under fluoroscopy ranged from 5 to 38 seconds. The interventionalist's exposure to radiation was significantly greater during procedures conducted on patients with LSS then during procedures on patients with HNP.
CONCLUSION: Adhering to a radiation safety program that includes maximizing the distance the spinal interventionalist is from the radiation source, decreasing exposure time, and proper shielding is essential when performing fluoroscopically guided lumbar TFESIs. Our study shows that exposure to radiation of the spinal interventionalist performing fluoroscopically guided lumbar TFESIs was well within safety limits when proper techniques were followed. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

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Year:  2002        PMID: 11994810     DOI: 10.1053/apmr.2002.32439

Source DB:  PubMed          Journal:  Arch Phys Med Rehabil        ISSN: 0003-9993            Impact factor:   3.966


  19 in total

1.  Radiation dose to the operator during fluoroscopically guided spine procedures.

Authors:  Luca Roccatagliata; Stefano Presilla; Emanuele Pravatà; Alessandro Cianfoni
Journal:  Neuroradiology       Date:  2017-07-18       Impact factor: 2.804

2.  Occupational radiation protection in interventional radiology: a joint guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology.

Authors:  Donald L Miller; Eliseo Vañó; Gabriel Bartal; Stephen Balter; Robert Dixon; Renato Padovani; Beth Schueler; John F Cardella; Thierry de Baère
Journal:  Cardiovasc Intervent Radiol       Date:  2009-12-18       Impact factor: 2.740

3.  Heavy metal pad shielding during fluoroscopic interventions.

Authors:  Sergio Dromi; Bradford J Wood; Jay Oberoi; Ziv Neeman
Journal:  J Vasc Interv Radiol       Date:  2006-07       Impact factor: 3.464

4.  Role of transforaminal epidural injections or selective nerve root blocks in the management of lumbar radicular syndrome - A narrative, evidence-based review.

Authors:  Vibhu Krishnan Viswanathan; Rishi Mugesh Kanna; H Francis Farhadi
Journal:  J Clin Orthop Trauma       Date:  2020-06-26

5.  Caudal Epidural Injections in Lumbar Spinal Stenosis: Comparison of Nonimage, Ultrasonography-, and Fluoroscopy-Guided Techniques. A Randomized Clinical Trial.

Authors:  Frideriki Poutoglidou; Dimitrios Metaxiotis; Angelo V Vasiliadis; Dimitrios Alvanos; Anastasios Mpeletsiotis
Journal:  Perm J       Date:  2021-06-09

6.  Radiation exposure to physicians during interventional pain procedures.

Authors:  Tae Wan Kim; Jang Hwan Jung; Hyun Joo Jeon; Kyung Bong Yoon; Duck Mi Yoon
Journal:  Korean J Pain       Date:  2010-03-10

7.  Complications and pitfalls of lumbar interlaminar and transforaminal epidural injections.

Authors:  Bradly S Goodman; Lyle W F Posecion; Srinivas Mallempati; Matt Bayazitoglu
Journal:  Curr Rev Musculoskelet Med       Date:  2008-08-15

8.  Cost comparison of nerve root infiltration of the lumbar spine under MRI and CT guidance.

Authors:  M H Maurer; N Schreiter; M de Bucourt; C Grieser; D M Renz; T Hartwig; B Hamm; F Streitparth
Journal:  Eur Radiol       Date:  2013-01-12       Impact factor: 5.315

9.  An Operator's Experience of the Loss-of-Resistance Technique in Epidural Injections: An Observational Study.

Authors:  Tulin Arici
Journal:  Eurasian J Med       Date:  2021-02

10.  Radiation dose reduction in CT-guided sacroiliac joint injections to levels of pulsed fluoroscopy: a comparative study with technical considerations.

Authors:  Juraj Artner; Balkan Cakir; Heiko Reichel; Friederike Lattig
Journal:  J Pain Res       Date:  2012-08-13       Impact factor: 3.133

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