title: Reducing radiation exposure during kyphoplasty with the use of a remote control injection system: a prospective study.
abstract: METHODS
  A prospective study.
  
  
  OBJECTIVE
  To compare surgeons' radiation exposure during kyphoplasty with and without the use of a remote control injection system.
  
  
  BACKGROUND
  Distance from radiation sources is a critical factor for reducing radiation exposure during spine surgery. A newly designed device was used to minimize operators' radiation exposure during kyphoplasty.
  
  
  METHODS
  Forty-four patients admitted for single-level osteoporotic vertebral compression fracture were randomly divided into 2 groups (groups A and B) and treated with kyphoplasty. The remote control injection system was used only in group B. The radiation doses to the surgeon's eyes, thyroid, chest, and right wrist were recorded with 4 unprotected radiometers simultaneously. Operation time, fluoroscopic time, cement amount, patient-reported pre- and postoperative visual analogue scale scores for pain, and complications were recorded.
  
  
  RESULTS
  For group A, the radiation doses at the eyes, thyroid, and right wrist were 1.132 ± 0.104 mSv, 0.647 ± 0.049 mSv, 0.578 ± 0.056 mSv, and 1.877 ± 0.214 mSv, respectively; for Group B, these doses were 0.257 ± 0.067 mSv, 0.201 ± 0.049 mSv, 0.145 ± 0.033 mSv, and 0.353 ± 0.046 mSv, respectively (P < 0.05). Comparisons of the radiation doses the chief surgeon and the resident surgeon received showed that the resident surgeon received more radiation during group A procedures; during group B procedures, the surgeons received similar doses. The proportion of average fluoroscopic time devoted to the bone cement injection step for groups A and B was 64% and 63%, respectively, and the average proportion of the radiation doses that were received during the bone cement injection step was 66% for group A and 36% for group B. Compared with the preoperative visual analogue scale score, the postoperative visual analogue scale score was significantly reduced in both groups.
  
  
  CONCLUSIONS
  During kyphoplasty, the use of the remote control injection system can significantly reduce surgeons' radiation exposure without affecting the efficiency of procedures.
authors.affiliation: *Department of Spine Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; and †Department of Orthopedics, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
authors.forename: Jianru
authors.initials: J
authors.lastname: Wang
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.forename: Kuibo
authors.initials: K
authors.lastname: Zhang
authors.forename: Bingxue
authors.initials: B
authors.lastname: Li
authors.forename: Hao
authors.initials: H
authors.lastname: Yang
authors.forename: Hua
authors.initials: H
authors.lastname: Wang
authors.forename: Zhaomin
authors.initials: Z
authors.lastname: Zheng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000627:therapeutic use; D005260:Female; D050815:Fractures, Compression / Q000601:surgery*; D006801:Humans; D058498:Kyphoplasty / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000517:prevention & control*; D011829:Radiation Dosage; D016103:Spinal Fractures / Q000601:surgery*
chemical_list: D001843:Bone Cements