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In Vitro Study of Patient's and Physician's Radiation Exposure in the Performance of Epiduroscopy
  1. Kaori Komiya, M.D.,
  2. Takashi Igarashi, M.D.,
  3. Hideo Suzuki, M.D.,
  4. Yoshihiro Hirabayashi, M.D.,
  5. Jason Waechter, M.D. and
  6. Norimasa Seo, M.D.
  1. Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan.

Abstract

Background and Objectives: Epiduroscopy is a minimally invasive diagnostic and therapeutic technique, useful in the management of patients with back and leg pain. However, the dose of radiation exposure by fluoroscopy during epiduroscopy is not known. The endpoint of our study was to evaluate the amount of radiation exposure for patients and health care workers during epiduroscopy.

Methods: First, we measured the radiation dose during a 10-minute fluoroscopy exposure in humanoid models, which substituted for the patient and the physician. Second, we measured the duration of fluoroscopy during our clinical epiduroscopy in 14 patients and observed for radiation injury in these patients.

Results: In the humanoid models, the patient model skin exposure dose over a 10-minute period was measured as 238 mGy. The physician's exposure dose for 10 minutes was measured as 0.67 mGy outside the lead apron and 0.0084 mGy inside the lead apron. For the clinical epiduroscopic procedures, the average duration of fluoroscopy was 9 minutes and 26 seconds. No skin injuries in the patients were observed at a 1-month postprocedure assessment.

Conclusions: The radiological dosages in the patient humanoid model were less than the threshold doses that could lead to organ injuries for 1 epiduroscopic procedure. However, care should be taken for cumulative exposures in repeated procedures.

  • Epiduroscopy
  • Radiation exposure
  • Fluoroscopy

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Footnotes

  • Reprint requests: Kaori Komiya, M.D., Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498 Japan. E-mail: komiya{at}jichi.ac.jp