title: Comparing radiation exposure during percutaneous vertebroplasty using one- vs. two-fluoroscopic technique.
abstract: BACKGROUND
  Percutaneous vertebroplasty (PV) requires relatively lengthy fluoroscopic guidance, which might lead to substantial radiation exposure to patients or operators. The two-fluoroscopic technique (two-plane radiographs obtained using two fluoroscopes) during PV can provide simultaneous two-planar projections with reducing operative time. However, the two-fluoroscopic technique may expose the operator or patient to increased radiation dose. The aim of this study was to quantify the amount of radiation exposure to the patient or operator that occurs during PV using one- vs. two-fluoroscopic technique.
  
  
  METHODS
  Two radiation dosimeters were placed on the right flank of each patient and on the upper sternum of each operator during 26 single-level PV procedures by one senior surgeon. The use of two-fluoroscopic technique (13 patients) and one-fluoroscopic technique (13 patients) were allocated in a consecutive and alternative manner. The operative time and mean radiation dose to each patient and operator were monitored and compared between groups.
  
  
  RESULTS
  Mean radiation dose to the patient was 1.97±1.20 mSv (95% CI, 0.71 to 3.23) for the one-fluoroscopic technique group vs. 0.95±0.34 mSv (95% CI, 0.85 to 1.23) for the two-fluoroscopic technique group (P=0.031). Mean radiation dose to the operator was 0.27±0.12 mSv (95% CI, 0.17-0.56) for the one-fluoroscopic technique group vs. 0.25±0.14 mSv (95% CI, 0.06-0.44) for the two-fluoroscopic technique group (P=0.653). The operative time was significantly different between groups: 47.15±13.48 min (range, 20-75) for the one-fluoroscopic technique group vs. 36.62±8.42 min (range, 21-50) for the two-fluoroscopic technique group (P=0.019).
  
  
  CONCLUSIONS
  Compared to the one-fluoroscopic technique, the two-fluoroscopic technique used during PV provides not only shorter operative times but also reduces the radiation exposure to the patient. There was no significant difference between the two techniques with regards to radiation exposure to the operator.
authors: Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, No6 W Sec, Chia-pu Rd, Putz City, Chiayi County, 613, Taiwan. orthoyao@cgmh.org.tw
authors: Yen-Yao
authors: YY
authors: Li
authors: Tsung-Jen
authors: TJ
authors: Huang
authors: Chin-Chang
authors: CC
authors: Cheng
authors: Meng-Huang
authors: MH
authors: Wu
authors: Ching-Yu
authors: CY
authors: Lee
mesh_terms: D005471:Fluoroscopy; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D016273:Occupational Exposure / Q000009:adverse effects / Q000517:prevention & control; D011446:Prospective Studies; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control; D015641:Radiography, Interventional / Q000009:adverse effects / Q000379:methods*; D012307:Risk Factors; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013624:Taiwan; D013819:Thermoluminescent Dosimetry; D013997:Time Factors; D054854:Vertebroplasty / Q000009:adverse effects / Q000379:methods*