Literature DB >> 12812967

Radiation dose to the operator during vertebroplasty: prospective comparison of the use of 1-cc syringes versus an injection device.

David F Kallmes1, Erwin O, Soma Sinha Roy, Richard G Piccolo, William F Marx, Jae K Lee, Mary E Jensen.   

Abstract

BACKGROUND AND
PURPOSE: Percutaneous vertebroplasty procedures require relatively long durations of fluoroscopic guidance, which might lead to substantial radiation dose to operators. Specialized injection devices have been proposed to limit operator exposure. Our purpose was to compare the radiation dose to the operator's hands during vertebroplasty when using 1-cc syringes versus that when using an injection device.
METHODS: Radiation dosimeters were worn on the left wrist during 39 vertebroplasty injection procedures in 25 patients. Cases were alternated between the use of 1-cc syringes (19 procedures) and the use of an injection device (20 procedures). For each procedure, one dosimeter was worn throughout the procedure, both during needle placement and injection, and a second dosimeter was worn during the injection phase only. Mean doses for the whole case and mean doses for the injection procedure alone were compared between groups.
RESULTS: Mean whole case dose was 128 +/- 161 mrem (range, 0-660 mrem) for the 1-cc syringe group versus 98 +/- 90 mrem (range, 0-340 mrem) for the injection device group (P =.23). Mean dose during injection was 100 +/- 145 mrem (range, 0-660 mrem) for the 1-cc syringe group versus 55 +/- 43 mrem (range, 0-130 mrem) for the injection device group (P =.09). Three of 19 1-cc syringe cases yielded zero dose, compared with four of 20 injection device cases. Duration of injection was markedly different between groups, with mean injection times of 4.2 and 7.5 min for 1-cc syringe and injection device cases, respectively (P <.00002). Mean injection dose per minute of lateral fluoroscopy was 23.6 and 7.3 mrem for the 1-cc syringe and injection device groups, respectively (P =.002).
CONCLUSION: The use of an injection device significantly decreased the radiation dose to the operator's extremity per unit time of injection. However, total dose per injection was equivalent between groups because of significantly longer injection duration for the injection device cohort.

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Year:  2003        PMID: 12812967      PMCID: PMC8149000     

Source DB:  PubMed          Journal:  AJNR Am J Neuroradiol        ISSN: 0195-6108            Impact factor:   3.825


  10 in total

1.  Percutaneous vertebroplasty: a special syringe for cement injection.

Authors:  I Al-Assir; A Perez-Higueras; J Florensa; A Muñoz; E Cuesta
Journal:  AJNR Am J Neuroradiol       Date:  2000-01       Impact factor: 3.825

2.  Unilateral transpedicular percutaneous vertebroplasty: initial experience.

Authors:  Ann K Kim; Mary E Jensen; Jacques E Dion; Patricia A Schweickert; Timothy J Kaufmann; David F Kallmes
Journal:  Radiology       Date:  2002-03       Impact factor: 11.105

3.  Vertebroplasty: reusable flange converter with hub lock for injection of polymethylmethacrylate with screw-plunger syringe.

Authors:  Eric H Schallen; Louis A Gilula
Journal:  Radiology       Date:  2002-03       Impact factor: 11.105

4.  Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy.

Authors:  A Gangi; B A Kastler; J L Dietemann
Journal:  AJNR Am J Neuroradiol       Date:  1994-01       Impact factor: 3.825

5.  Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects.

Authors:  M E Jensen; A J Evans; J M Mathis; D F Kallmes; H J Cloft; J E Dion
Journal:  AJNR Am J Neuroradiol       Date:  1997 Nov-Dec       Impact factor: 3.825

6.  Relevance of antecedent venography in percutaneous vertebroplasty for the treatment of osteoporotic compression fractures.

Authors:  John R Gaughen; Mary E Jensen; Patricia A Schweickert; Timothy J Kaufmann; William F Marx; David F Kallmes
Journal:  AJNR Am J Neuroradiol       Date:  2002-04       Impact factor: 3.825

Review 7.  Percutaneous vertebroplasty: state of the art.

Authors:  A Cotten; N Boutry; B Cortet; R Assaker; X Demondion; D Leblond; P Chastanet; B Duquesnoy; H Deramond
Journal:  Radiographics       Date:  1998 Mar-Apr       Impact factor: 5.333

8.  Percutaneous vertebroplasty for pain relief and spinal stabilization.

Authors:  J D Barr; M S Barr; T J Lemley; R M McCann
Journal:  Spine (Phila Pa 1976)       Date:  2000-04-15       Impact factor: 3.468

9.  Predictive value of intraosseous venography before percutaneous vertebroplasty.

Authors:  J Kevin McGraw; Eric V Heatwole; Bradley T Strnad; Jeffrey S Silber; Shayle B Patzilk; Jeffrey M Boorstein
Journal:  J Vasc Interv Radiol       Date:  2002-02       Impact factor: 3.464

10.  Is percutaneous vertebroplasty without pretreatment venography safe? Evaluation of 205 consecutives procedures.

Authors:  Cristiana Vasconcelos; Philippe Gailloud; Norman J Beauchamp; Donald V Heck; Kieran J Murphy
Journal:  AJNR Am J Neuroradiol       Date:  2002 Jun-Jul       Impact factor: 3.825

  10 in total
  14 in total

1.  [Guidelines of the German Radiological Society for percutaneous vertebroplasty].

Authors:  T Helmberger; K Bohndorf; J Hierholzer; G Nöldge; D Vorwerk
Journal:  Radiologe       Date:  2003-09       Impact factor: 0.635

Review 2.  Occupational radiation doses to operators performing fluoroscopically-guided procedures.

Authors:  Kwang Pyo Kim; Donald L Miller; Amy Berrington de Gonzalez; Stephen Balter; Ruth A Kleinerman; Evgenia Ostroumova; Steven L Simon; Martha S Linet
Journal:  Health Phys       Date:  2012-07       Impact factor: 1.316

3.  Percutaneous vertebroplasty performed by the isocenter puncture method.

Authors:  Shinjirou Sakaino; Kenji Takizawa; Misako Yoshimatsu; Yukihisa Ogawa; Kunihiro Yagihashi; Yasuo Nakajima
Journal:  Radiat Med       Date:  2008-02-27

4.  Fluoroscopic Radiation Exposure during Percutaneous Kyphoplasty.

Authors:  Hyun-Chul Choi
Journal:  J Korean Neurosurg Soc       Date:  2011-01-31

5.  Significantly reduced radiation exposure to operators during kyphoplasty and vertebroplasty procedures: methods and techniques.

Authors:  A O Ortiz; V Natarajan; D R Gregorius; S Pollack
Journal:  AJNR Am J Neuroradiol       Date:  2006-05       Impact factor: 3.825

6.  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

7.  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

8.  Radiation Exposure of the Hand and Chest during C-arm Fluoroscopy-Guided Procedures.

Authors:  Cheol Hee Jung; Jae Sung Ryu; Seung Woo Baek; Ji Hye Oh; Nam Sik Woo; Hae Kyoung Kim; Jae Hun Kim
Journal:  Korean J Pain       Date:  2013-01-04

9.  Reduction of radiation dose during facet joint injection using the new image guidance system SabreSource: a prospective study in 60 patients.

Authors:  Dirk Proschek; K Kafchitsas; M A Rauschmann; A A Kurth; T J Vogl; Florian Geiger
Journal:  Eur Spine J       Date:  2008-12-11       Impact factor: 3.134

10.  Evaluation of operator radioprotection using a new injection device during vertebroplasty.

Authors:  L Nguyen-Kim; C Fargeot; H Beaussier; S Payen; J Chiras
Journal:  Interv Neuroradiol       Date:  2013-05-21       Impact factor: 1.610

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