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Radiation exposure in percutaneous spinal cord stimulation mapping: a preliminary report
Kevin L Wininger1, Kedar K Deshpande, Keshav K Deshpande
1Orthopaedic & Spine Center, Columbus, OH 43240, USA. orthopaedicandspinecenter.com
Pain Physician
|February 2, 2010
Summary
This study reports on radiation exposure during spinal cord stimulation (SCS) trialing, finding considerable fluoroscopy times but low risk of skin injury. These findings provide initial benchmarks for SCS procedures.
Area of Science:
- Pain Management
- Neurosurgery
- Radiology
Background:
- Spinal cord stimulation (SCS) is increasingly used for intractable pain.
- Fluoroscopy is essential for SCS trialing, requiring radiation exposure measurements.
- Literature data on radiation exposure during SCS trialing is lacking.
Purpose of the Study:
- To quantify radiation exposure during percutaneous SCS trialing procedures.
Main Methods:
- Retrospective observational study of 110 SCS trialing procedures.
- Data collected from a US outpatient Interventional Pain Management practice.
- Fluoroscopy time and incident air kerma were analyzed using a mobile C-arm system.
Main Results:
- Mean fluoroscopy time was 133.4 seconds (SD 84.8s), with 31.9% pulsed fluoroscopy.
- For dual leads in the low-thoracic region (n=87), fluoroscopy time ranged from 28.5s to 387.4s.
- Incident air kerma ranged from 1.8 to 43.7 mGy.
Conclusions:
- This preliminary report provides initial benchmark estimates for fluoroscopy times and radiation exposure in SCS trialing.
- Fluoroscopy times can be substantial compared to other pain procedures.
- The risk of skin injury from radiation during these procedures is considered improbable.
