Protecting Surgeons' Fingers from Radiation Exposure during Lumbosacral Selective Nerve Root Block.

Autor:	Omi H; Department of Orthopedic Surgery, Aomori Prefectural Central Hospital, Aomori, Japan., Itabashi T; Department of Orthopedic Surgery, Towada City Hospital, Aomori, Japan., Nagaoki T; Department of Orthopedic Surgery, Aomori Prefectural Central Hospital, Aomori, Japan., Ogawa T; Department of Orthopedic Surgery, Mutsu General Hospital, Aomori, Japan., Tomita T; Department of Orthopedic Surgery, Aomori Prefectural Central Hospital, Aomori, Japan., Sato H; Department of Orthopedic Surgery, Aomori Prefectural Central Hospital, Aomori, Japan., Ito J; Department of Orthopedic Surgery, Aomori Prefectural Central Hospital, Aomori, Japan.
Jazyk:	angličtina
Zdroj:	Spine surgery and related research [Spine Surg Relat Res] 2018 Nov 10; Vol. 3 (2), pp. 178-182. Date of Electronic Publication: 2018 Nov 10 (Print Publication: 2019).
DOI:	10.22603/ssrr.2018-0056
Abstrakt:	Introduction: Fluoroscopy-guided selective nerve root block (SNRB) is useful for the diagnosis and treatment of nerve root pain. However, the procedure exposes the surgeon's hands to radiation. Therefore, the purpose of this randomized prospective study was to assess the radiation exposure per unit time of the surgeon's fingers during performance of a lumbosacral SNRB and to calculate the annual exposure time limits for four hand-protection methods. Methods: We prospectively recruited patients scheduled for an SNRB and measured the radiation exposure using a ring-type passive radiation dosimetry device attached to the distal phalanx of the index finger of the hand performing the needle placement. Patients were randomly divided into the following four groups: a) the direct exposure group, b) the 0.03-mmPb glove group, c) the 0.25-mmPb glove group, and d) the forceps group (in which the needle was held using forceps such that the fingers did not enter the irradiation field). Results: We recruited 40 consecutive patients (16 men and 24 women), with a mean age of 69 years. In all cases, SNRB was successfully performed without complications. The average exposure per hour for each of the four groups was as follows: 0.67 ± 0.56 mSv/s in the direct exposure group, 0.12 ± 0.07 mSv/s in the 0.03-mmPb glove group, 0.019 ± 0.02 mSv/s in the 0.25-mmPb glove group, and 0.001 ± 0.004 mSv/s in the forceps group (p < 0.01). The average annual exposure time limit was 12.4 min in the direct exposure group, 67.9 min in the 0.03-mmPb glove group, 7.5 h in the 0.25-mmPb glove group, and 5.0 days in the forceps group. Conclusions: Using a radiation reduction glove or forceps greatly decreased the radiation exposure and increased the annual exposure time limit for SNRB. Competing Interests: Conflicts of Interest: The authors declare that there are no relevant conflicts of interest.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu