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- Title
Patient and physician radiation exposure during minimally invasive lumbar decompression: A prospective assessment of X‐ray exposure risks.
- Authors
Mekhail, Nagy; Topalsky, Krista; Templeton, Erin; Armanyous, Sherif; Prayson, Nicholas; Olde, Carl; Costandi, Shrif
- Abstract
Introduction: Minimally invasive lumbar decompression (mild®) is becoming a popular procedure for treating lumbar spinal stenosis (LSS) secondary to hypertrophic ligamentum flavum (LF). The mild® procedure is commonly performed under live fluoroscopic guidance and carries a risk of radiation exposure to the patient and healthcare. Methods: One physician performed mild® on 41 patients at the Cleveland Clinic Department of Pain Management from October 2019 to December 2021, while wearing a radiation exposure monitor (Mirion Technologies). Mean fluoroscopy time, mean exposure per case, and mean exposure per unilateral level decompressed were the primary outcomes measured. The secondary outcome was to provide a comparison of radiation exposure during similar fluoroscopically guided procedures. Results: Mean patient fluoroscopy exposure time was 2.1 min ±0.9 (range: 1.1–5.6) fluoroscopy time per unilateral level decompressed. The mean patient radiation skin exposure from mild® was 1.1 ± 0.9 mGym2, and the mean total dose was 142.3 ± 108.6 mGy per procedure. On average, the physician was exposed to an average deep tissue exposure of 4.1 ± 3.2 mRem, 2.9 ± 2.2 mRem estimated eye exposure, and 14.7 ± 11.0 mRem shallow tissue exposure per unilateral level decompressed. An individual physician would exceed the annual exposure limit of 5 Rem after approximately 610 mild® procedures per year. Conclusions: This study is an attempt to quantify the radiation exposure to the physician and patient during the mild® procedure. Compared with other fluoroscopically guided pain management procedures, patient and physician radiation exposure during mild® was low.
- Subjects
SPINAL stenosis treatment; PSYCHOLOGY of physicians; RISK assessment; PATIENT safety; RESEARCH funding; RADIATION injuries; MINIMALLY invasive procedures; TREATMENT effectiveness; DESCRIPTIVE statistics; OCCUPATIONAL exposure; LUMBAR vertebrae; X-rays; PATIENT monitoring; RADIATION doses; SURGICAL decompression; FLUOROSCOPY; EVALUATION; DISEASE risk factors
- Publication
Pain Practice, 2024, Vol 24, Issue 4, p600
- ISSN
1530-7085
- Publication type
Article
- DOI
10.1111/papr.13329