Radiation-Shielding Devices: The Best Combination for Spine Interventional Procedures

Area of Science:

• Medical Physics
• Radiology
• Interventional Pain Management

Background:

• Physicians performing interventional pain procedures face significant radiation exposure during C-arm fluoroscopy.
• Existing studies focus on individual protective devices, but combinations have not been systematically evaluated.
• Optimizing radiation shielding is crucial for physician safety and long-term health.

Purpose of the Study:

• To determine the most effective combination of radiation-shielding devices for physicians during simulated lumbar epidural injections.
• To compare the radiation protection efficiency (RPE) of various single and combined protective measures.

Main Methods:

• Prospective experimental study using anthropomorphic physician and patient phantoms.
• Radiation doses measured with personal electronic dosimeters at eye, thyroid, and gonad levels.
• Evaluated personal protective equipment (PPE), bedside curtain shield (Curtain), x-ray tube filter (Filter), and fluoroscopic collimation (Collimation) individually and in combination.

Main Results:

• Single best protection: PPE (80.04% RPE).
• Double combination best: PPE + Collimation (92.09% RPE).
• Triple combination best: PPE + Collimation + Curtain (93.39% RPE).
• Quadruple combination (PPE + Collimation + Curtain + Filter) offered minimal additional benefit (93.61% RPE).

Conclusions:

• The optimal combination for radiation protection is PPE, fluoroscopic collimation, and a bedside curtain shield.
• Prioritize PPE, then add collimation, followed by the curtain shield for enhanced safety.
• Findings provide a practical guideline for selecting radiation-shielding equipment in interventional procedures.