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Fluoroscopic radiation exposure during spinal cord stimulation procedures: A systematic review and meta-analysis
Chelsie L Jacques1, Andrew R Stephens1, Ramzi El-Hassan1
1Department of Physical Medicine and Rehabilitation, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY, USA.
Purpose:
Assess the fluoroscopic exposure times of spinal cord stimulator lead placement using systematic review and meta-analysis.
Study Design:
Systematic Review and Meta-Analysis.
Methods:
Major databases including PubMed, Embase, CINAHL, Cochrane Library, Scopus, Web of Science were used to conduct a systematic review with key terms regarding radiation (i.e. "radiation," "fluoroscopy," "dose area product" etc.) and spine procedures (i.e. "spinal cord stimulator," "injections"). Initial review of abstracts and titles were performed to filter content, followed by full text review by independent authors. Studies that provided fluoroscopic exposure times for percutaneous spinal cord stimulator lead trial and implants were included. Mean and standard deviations for fluoroscopy times (seconds) were compared.
Results:
449 patients were included in this study across all studies. Of the total number of patients, 429 received SCS trials and 20 received SCS implants. The range of fluoroscopy time averages during SCS trials was 7 ± 4.4 s to 289 ± 198 s.
Discussion:
This study provided an initial reference for fluoroscopic times during spinal cord stimulator trials. The fairly limited amount of information found prompts further dialogue and investigative studies on variables that should be accounted for when discussing radiation exposure during interventional procedures.
