Uncertainty and Relative Risks of Radiation Exposure

Adelstein, S. James

doi:10.1001/jama.1987.03400050097034

Cited by 20 publications

(5 citation statements)

References 6 publications

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“…This has been found by other authors (42). It should be noted the long term effects of low dose radiation are uncertain (43). The exposure in our study was greater to the hands, than eyes of our interventionalists, which may argue for even the use of leaded gloves in addition to leaded glasses.…”

Section: Discussionmentioning

confidence: 71%

Radiation Exposure to the Spinal Interventionalist Performing Lumbar Discography

Botwin

2003

Pain Phys

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Section: Discussionmentioning

confidence: 71%

Radiation Exposure to the Spinal Interventionalist Performing Lumbar Discography

Botwin

2003

Pain Phys

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“…However, the absolute exposure to orthopedic surgeons must be calculated on an individual basis, taking into account that radiation exposure is cumulative over a lifetime. At present, the long-term effects of low-dose radiation remain unknown [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Radiation Exposure to the Hand of a Spinal Interventionalist during Fluoroscopically Guided Procedures

et al. 2017

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Study DesignProspective study.PurposeDuring fluoroscopically guided spinal procedure, the hands of spinal surgeons are placed close to the field of radiation and may be exposed to ionizing radiation. This study directly measured the radiation exposure to the hand of a spinal interventionalist during fluoroscopically guided procedures.Overview of LiteratureFluoroscopically guided spinal procedures have been reported to be a cause for concern due to the radiation exposure to which their operators are exposed.MethodsThis prospective study evaluated the radiation exposure of the hand of one spinal interventionalist during 52 consecutive fluoroscopic spinal procedures over a 3-month period. The interventionalist wore three real-time dosimeters secured to the right forearm, under the lead apron over the chest, and outside the lead apron over the chest. Additionally, one radiophotoluminescence glass dosimeter was placed under the lead apron over the left chest and one ring radiophotoluminescence glass dosimeter was worn on the right thumb. The duration of exposure and radiation dose were measured for each procedure.ResultsThe average radiation exposure dose per procedure was 14.9 µSv, 125.6 µSv, and 200.1 µSv, inside the lead apron over the chest, outside the lead apron over the chest, and on the right forearm, respectively. Over the 3-month period, the protected radiophotoluminescence glass dosimeter over the left chest recorded less than the minimum reportable dose, whereas the radiophotoluminescence glass ring dosimeter recorded 368 mSv for the thumb.ConclusionsOur findings indicated that the cumulative radiation dose measured at the dominant hand may exceed the annual dose limit specified by the International Commission on Radiological Protection. Spinal interventionalists should take special care to limit the duration of fluoroscopy and radiation exposure.

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“…However, if the tube current is set too high to achieve better quality images, the entire advantage of pulsed operation is defeated and there may be no actual dose savings (26). Others also have shown to reduce overall exposure by 20% to 75% during pulsed fluoroscopy (48,49).…”

Section: Table 2 Illustration Of Radiation Exposure In 1000 Patientsmentioning

confidence: 99%

Radiation Exposure to the Physician in Interventional Pain Management

Manchikanti

Ka²,

Tl³

et al. 2002

Pain Phys

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Fluoroscopy is an integral part of the practice of interventional pain management in present day modern medical practices. The major purpose of fluoroscopy in interventional pain management is correct needle placement to ensure target specificity and accurate delivery of the injectate. Fluoroscopy has become mandatory for multiple procedures based either on the definition of the procedure or the requirement of third parties. The most commonly used fluoroscopy in interventional pain management is with C-arm fluoroscopes with image intensification. Fluoroscopy is associated with risk for patients, clinicians, and the personnel in the operating room unless it is managed with appropriate understanding, skill, and vigilance.A total of 1,000 consecutive patients undergoing interventional procedures with chronic pain performed by one physician were studied. Two fluoroscopy units were utilized and operated by two certified radiological technologists. The procedures performed included caudal and interlaminar epidural injections, facet joint nerve blocks, percutaneous adhesiolysis, intercostal nerve blocks, sympathetic blocks, transforaminal epidural injections, along with other procedures. Results showed that a total of 1,000 patients underwent 1,729 procedures with average radiation exposure of 13.2 ± 0.33 seconds per patient and 7.7 ± 0.21 seconds per procedure. Dosimetry measurements showed total exposure of 1,345 mREM outside the apron and 0 mREM inside the apron during this period. The average exposure outside the apron was 1.345 mREM per patient and 0.748 mREM per procedure outside the apron and 0 mREM inside the apron. The levels of exposure are significantly below the annual limits recommended. It is concluded that it is feasible to perform all procedures under fluoroscopy in the described setting safely and effectively in interventional pain management.

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Uncertainty and Relative Risks of Radiation Exposure

Cited by 20 publications

References 6 publications

Radiation Exposure to the Spinal Interventionalist Performing Lumbar Discography

Radiation Exposure to the Spinal Interventionalist Performing Lumbar Discography

Radiation Exposure to the Hand of a Spinal Interventionalist during Fluoroscopically Guided Procedures

Radiation Exposure to the Physician in Interventional Pain Management

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