Surgeon's and Patient's Radiation Exposure Through Vertebral Body Cement Augmentation Procedures: A Prospective Multicentric Study of 49 Cases.
OBJECTIVE
Vertebral body cement augmentation as a treatment option for osteoporotic or traumatic fractures has become increasingly popular during the past decade. However, these surgical procedures require numerous fluoroscopic examinations, resulting in high radiation exposure for the patient and the surgical team. The aim of this study was to evaluate the level of radiation exposure of the spine surgeon and the patient during these percutaneous procedures.


METHODS
Forty-nine patients admitted for single- or 2-level vertebral compression fracture were prospectively included and treated with vertebral body cement augmentation. For each procedure, radiation dose was measured on the surgeon's whole body, lens, and extremities as well as patient irradiation. Each surgeon wore 2 thermoluminescent dosimeters to measure lens and extremities radiation exposure and 1 electronic personal dosimeter. Patient clinical and surgical data, effective dose to patient, and surgeon were analyzed.


RESULTS
Mean operative time was 31.5 ± 11.7 minutes. The average fluoroscopic time was 61.0 ± 27.1 seconds. The average whole-body radiation dose per procedure was 1.4 ± 2.1 μSv. The average equivalent dose to lens and extremities were 44 μSv and 59 μSv, respectively.


CONCLUSIONS
Values of radiation doses for surgeon and patient were lower than those reported in the previous literature. The recommended annual dose limit is set to 500 mSv for extremities and 150 mSv for lens. According to our results, the exposure dose to the eye exceeds the annual limit after 3500 procedures. However, there is increasing concern among surgeons about radiation exposure, and there is still a need for solutions as preventive measures.
Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier, France. Electronic address: nlonjon@gmail.com.
Nicolas
N
Lonjon
Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier, France.
Marine
M
Le Corre
Department of Medical Physics, Montpellier University Hospital, Montpellier Cedex, France.
Julien
J
Le Roy
Department of Radiology, Nîmes University Hospital, Medical Imaging Group Nîmes, Nîmes Cedex, France.
Joël
J
Greffier
Department of Neurosurgery, CHU la Timone, Marseille, France.
Stéphane
S
Fuentes
Department of Orthopedic Surgery, Hôpital Michalon CHU Grenoble Nord, Grenoble, France.
Jérôme
J
Tonetti
Department of Spine Surgery, Pavillon Chirurgical B-Hôpitaux universitaires de Strasbourg, Strasbourg Cedex, France.
Yann Philippe
YP
Charles
Spine Unit, CHU Timone, Aix-Marseille University, Marseille, France.
Benjamin
B
Blondel
Department of Orthopedic and Spine Surgery, Hôpital Universitaire Carémeau, Nîmes, France.
Pascal
P
Kouyoumdjïan
D005260:Female; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069471:Neurosurgeons / Q000706:statistics & numerical data*; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D011446:Prospective Studies; D000069079:Radiation Exposure / Q000706:statistics & numerical data*; D015641:Radiography, Interventional / Q000706:statistics & numerical data*; D018570:Risk Assessment; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D054854:Vertebroplasty / Q000706:statistics & numerical data*
Fluoroscopy; Fracture; Radiation exposure; Spine surgeon; Vertebral body augmentation