Non-invasive, fluoroscopy-based, image-guided surgery reduces radiation exposure for vertebral compression fractures: A preliminary survey

SummaryBackgroundPercutaneous vertebroplasty has gained widespread popularity to treat painful osteoporotic vertebral compression fractures (VCFs). Radiation exposure during these operations has become the major concern in recent years.AimsTraditional percutaneous vertebroplasty for VCFs is associated with high operator radiation exposure. However, these procedures can be performed by fluoroscopy-based image guidance, which decreases the radiation exposure during vertebroplasty for VCFs.MethodsThe study subjects were divided into two groups: one underwent traditional vertebroplasty and the other had the C-Arm fluoroscopy-based, image-guided procedure. Four patients in the first group underwent traditional vertebroplasty using repeated intermittent anteroposterior and lateral fluoroscopy to position the cannula used for the vertebroplasty. Six patients in the second group had C-Arm fluoroscopy-based, image-guided surgery. The dose area product values, obtained by thermoluminescent dosimeters, were measured in both groups.ResultsThe accuracy of the non-invasive fluoroscopy-based image-guided surgery was high, with a maximum error of 2 mm. The mean dose area product values of the operator’s eyes, hands, neck and chest were 20.28 mGy, 20.34 mGy, 21.87 Gy and 18.27 mGy in the first group, and 3.51 mGy, 3.70 mGy, 3.02 mGy and 3.68 mGy in the second group, respectively, with fluoroscopy-based, image-guided surgery; the differences were statistically significant (p < 0.05).ConclusionThe results of this preliminary study showed that noninvasive, fluoroscopy-based, image-guided surgery was accurate and was associated with reduced radiation exposure to medical personnel during percutaneous vertebroplasty procedures for VCFs.