Does Updated Compared to Older Fluoroscopic Imaging Technology Reduce Radiation Dose During Interventional Spine Procedures? A Pragmatic Cohort Study.



fluoroscopy, radiation exposure, radiation dose, cervical interventional procedures, lumbar interventional procedures.



Objective: Determine if an updated model compared to an older model of a common fluoroscope reduces radiation dose during interventional spine procedures.

Methods: Retrospective cohort study containing patients who underwent fluoroscopically-guided spine procedures between April 2016-December 2016. Multivariate regression analysis performed to examine the mean radiation dose during various interventional spine procedures using a GE OEC 9800 and GE OEC 9900 machine. Age, sex, BMI, spinal level, trainee presence, and fluoroscopy time was used as covariates in order to control for possible confounding variations in patient demographics and procedure characteristics before and after implementation of the new fluoroscope.

Results: Total of 271 injection encounters(male=43.9%, age=58.6 ±13.4 years, BMI=29.0 ±6.8 kg/m2) were analyzed. There was no significant difference in radiation dose per procedure between the machines(2779 ±3158 mGycm2vs.2626 ±3147 mGycm2,p=0.689). The mean fluoroscopy dose per procedure was significantly higher for lumbar compared to cervical injections(3778 ±3736 mGycm2vs.1267 ±968 mGycm2,p<0.001). These results did not change after adjusting for covariates(p>0.05). Higher BMI and longer fluoroscopy time were significantly associated with greater radiation dose(p<0.001).


Conclusion: Radiation dose exposure during fluoroscopically-guided interventional spine/pain procedures was not significantly different when comparing an older- and newer-generation fluoroscope; this remained true after controlling for possible confounding variables.