Comparisons of the Amount of Radiation Exposure Among Medical Personnels in Percutaneous Vertebroplasty

Abstract

Objective: X-ray has been used for visualizing internal lesions despite of its biological hazard. Fluoroscopic technique is essential in the modern spinal interventions due to its simplicity and sharpness. Radiation hazard is often under estimated due to Intangible property and late effect. The purpose of this study was to assess radiation exposure during percutaneous vertebroplasty (PVP) which is one of the most frequently performed spinal interventions. Methods: We performed a prospective analysis of a total of 17 consecutive cases of PVP between January 2012 to august 2012. Sixteen patients were osteoporotic compression fractures. One case underwent PVP for pathological compression fracture. Exposure time was calculated automatically by a fluoroscope. For medical personnel, we put a thermoluminescent dosimeters (TLD) on the midpoint of the sternum inside a body apron and another one on the midpoint of a thyroid protector. For patients, one TLD was placed on the table anterior to patient's neck and another one on the table anterior to the treatment level. All TLDs were sent to the lab immediately after PVP. The cumulative dose recorded for each TLD badge was analyzed. Results: The exposure time per one vertebra was 323.77±23.96 seconds, ranging 207.00 to 547.00 seconds. The exposure dose measured on a thyroid protector was 2.97±0.54 mSv, ranging 2.11 to 3.21 mSv in the surgeon, 0.04±0.11 mSv, ranging 0.02 to 0.14 mSv in the assistant surgeon, and 0.11±0.02 mSv, ranging 0.08 to 0.15 mSv in the nurse. The exposure dose measured in the radio-protective apron was 0.20±0.04 mSv, ranging 0.15 to 0.30 mSv in the surgeon, 0.01±0.005, ranging 0.005 to 0.03 mSv in the assistant surgeon, and 0.04±0.01 mSv, ranging 0.02 to 0.10 mSv in the nurse. The patient showed 0.44±0.14 mSv, ranging 0.33 to 0.54 mSv in the neck area and 3.97. 0.52 mSv, ranging 3.44 to 4.12 mSv in the treated area. Conclusion: The amount of radiation exposure was different among medical personnel in performing PVP. The major contributing factor of this difference is supposed to be the distance from a fluoroscope. In addition to wear proper X-ray protective gears and reduce X-ray shooting time, we can further minimize radiation exposure by standing aside from the fluoroscope.