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Patient Exposure and Associated Radiation Risks from Fluoroscopically Guided Vertebroplasty or Kyphoplasty¹

¹ From the Departments of Medical Physics (K.P., J.D., N.T.), Orthopaedics and Traumatology (G.P., A.H.), and Radiology (N.G.), University Hospital of Iraklion, University of Crete, Faculty of Medicine, PO Box 2208, 71003 Iraklion, Crete, Greece. Received September 2, 2003; revision requested November 20; revision received December 10; accepted January 13, 2004. Address correspondence to K.P. (e-mail: perisina@med.uoc.gr).

View larger version (123K): [in a new window]   Figure 1. Lateral projections obtained during flurosocopically guided kyphoplasty show, A, biopsy needle through which a guide pin has been inserted into the fractured vertebra; B, cannula inserted over the guide pin after removal of the biopsy needle; C, inflatable bone tamp inserted into the deformed vertebra after removal of the guide pin; D, inflated balloon; E, void created by balloon inflation (arrow); and, F, void filled with polymethylmethacrylate cement after deflation and withdrawal of the balloon.

View larger version (22K): [in a new window]   Figure 2. Bar graph shows conversion factors for conversion from DAP to patient effective dose for anteroposterior (AP) and lateral (L) fluoroscopic projections. The factor varies, depending on the level of the treated vertebra, and treatment of L1 results in a higher effective dose than does treatment centered on any other vertebra.

View larger version (22K): [in a new window]   Figure 3. Bar graphs show conversion factors for conversion from DAP to gonadal dose for anteroposterior (AP) and lateral (L) fluoroscopic projections in, A, male and, B, female patients. The conversion factor depends on the treated vertebra and patient sex; gonadal dose is much higher for women than for men, for all treated vertebrae.

View larger version (25K): [in a new window]   Figure 4. Bar graph shows fatal cancer risks for female (white bars) and male (black bars) patients who underwent fluoroscopically guided kyphoplasty of L1 at the authors’ institution, according to patient age at kyphoplasty. Data were estimated by using U.S. population-derived age- and sex-related radiation risk coefficients (19). Patients younger than 30 years who underwent the procedure had a much higher associated risk for radiation-induced fatal cancer, compared with patients older than 30 years.