Patient radiation exposure during different kyphoplasty techniques

Area of Science:

• Medical Physics
• Interventional Radiology

Background:

• Kyphoplasty (KP) is a minimally invasive procedure to treat vertebral compression fractures.
• Patient radiation exposure during KP procedures is a significant concern.
• Different cement delivery techniques may influence radiation dose.

Purpose of the Study:

• To quantify and compare patient radiation exposure during two kyphoplasty (KP) cement delivery techniques: manual injection (Study A) and distance delivery (Study B).
• To determine if one technique offers reduced patient radiation dose.

Main Methods:

• Twenty patients undergoing kyphoplasty were analyzed.
• Radiation dose parameters including exposure time, Kerma-Area Product (KAP), Entrance Skin Dose (ESD), and Effective Dose (E) were monitored.
• Measurements were taken during anteroposterior (AP) and lateral (LL) fluoroscopic projections.

Main Results:

• The distance delivery technique (Study B) showed longer fluoroscopic times, particularly in the lateral projection (5.1 ± 0.6 min vs. 3.2 ± 0.7 min for Study A).
• Study B resulted in higher average Entrance Skin Dose (ESD) (0.13 ± 0.13 Gy AP/LL vs. 0.10 ± 0.06 Gy AP/LL for Study A).
• The cumulative mean Effective Dose (E) was substantially higher for Study B (3.6 ± 0.9 mSv) compared to Study A (1.9 ± 1.0 mSv).

Conclusions:

• Patient radiation exposure during kyphoplasty can be considerable.
• The distance cement delivery technique requires more prolonged fluoroscopic monitoring, leading to a higher radiation dose to the patient compared to manual injection.
• Choosing the appropriate cement delivery method is crucial for optimizing patient radiation safety in kyphoplasty.