Patient radiation exposure during different kyphoplasty techniques

Radiat Prot Dosimetry. 2014 Jan;158(2):230-4. doi: 10.1093/rpd/nct214. Epub 2013 Sep 12.

Abstract

The scope of this study was to quantify patient radiation exposure during two different techniques of kyphoplasty (KP), which differ by a cement delivery method, in order to assess whether or not one of the two used methods can reduce the patient dose. Twenty patients were examined for this investigation. One X-ray fluoroscopy unit was used for localization, navigation and monitoring of cement delivery. The patient biometric data, the setting of the fluoroscope, the exposure time and the kerma-area product (KAP) were monitored in all the procedures for anteroposterior (AP) and lateral (LL) fluoroscopic projections in order to assess the range of radiation doses imparted to the patient. Theoretical entrance skin dose (ESD) and effective dose (E) were calculated from intraoperatively measured KAP. An average ET per procedure was 1.5±0.5 min for the manual injection technique (study A) and 1.4±0.4 min for the distance delivery technique (study B) in the AP plane, while 3.2±0.7 and 5.1±0.6 min in the lateral plane, respectively. ESD was estimated as an average of 0.10±0.06 Gy for study A and 0.13±0.13 Gy for study B in the AP or/and 0.59±0.46 and 1.05±0.36 Gy in the lateral view, respectively. The cumulative mean E was 1.9±1.0 mSv procedure(-1) for study A and 3.6±0.9 mSv procedure(-1) for study B. Patient radiation exposure and associated effective dose from KP may be considerable. The technique of distance cement delivery appears to be slower than the manual injection technique and it requires a more protracted fluoroscopic control in the lateral projection, so that this system entails a higher amount of dose to the patient.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Cements
  • Equipment Design
  • Female
  • Fluoroscopy / methods
  • Humans
  • Kyphoplasty / adverse effects*
  • Kyphoplasty / methods*
  • Male
  • Middle Aged
  • Radiation Dosage*
  • Radiography, Interventional / methods*
  • Radiometry
  • Spinal Fractures / therapy
  • X-Rays

Substances

  • Bone Cements