LB25 Cumulative radiation dose exposure in fluoroscopy-guided epidural interlaminar lumbar steroid injections

Abstract

<h3>Background and Aims</h3> Fluoroscopy-guided epidural interlaminar steroid injections (FEISI) widely used for managing low back pain (LBP). There is lack of data on cumulative radiation dose (CRD) in patients receiving more than one FEISI (1). it is very important to determine CRD for three consecutive FEISI and to define factors that correlate with higher dose area product (DAP) or prolong fluoroscopy time (FT). <h3>Methods</h3> Three groups of patients: LBP duration for one, two and more than two years. One-way ANOVA and independent t-test used to compare FT. <h3>Results</h3> 64 females and 36 males (mean age 51 y.o.), mean LBP time 2.1 years. Mean cumulative DAP 833.54cGycm2 (SD 266.32), mean FT 62.23s (SD 13.22s); strong positive correlation between FT and DAP (r=0.545; p=0.01). Mean FT during 1st procedure 18.1s, 2nd - 20.7s, 3rd - 23.43s. Mean DAP during 1st procedure 226.24cGycm2, 2nd - 257.33cGycm2, 3rd - 349.97cGycm2. FT and DAP positively correlate in each group. First epidural steroid injection time p=0.750, 2nd 0.767, 3rd 0.682 (p=0.01). First FT was longer in LBP for more than 2 years (p=0.05) n=38 (mean 25.4s); LBP less than 1 year n=36 (mean 22.51s) and LBP from 1–2 years n=26 (mean 14.32s). Mean DAP was higher during 3 procedures and LBP longer than 5 years (p=0.05). <h3>Conclusions</h3> DAP is in uphill linear relationship with FT. Mean cumulative dose is 57 times lower than radiation dose for FEISI allowed by Society of Interventional Radiology of Europe. Patients with longer LBP have longer FT and higher DAP, probably due to severe degenerative spinal lesions.