Elsholtz, Fabian Henry Jürgen;
Schaafs, Lars-Arne;
Köhlitz, Thorsten;
Hamm, Bernd;
Niehues, Stefan Markus
Periradicular infiltration of the lumbar spine: testing the robustness of an interventional ultra-low-dose protocol at different body mass index levels
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Media type:
E-Article
Title:
Periradicular infiltration of the lumbar spine: testing the robustness of an interventional ultra-low-dose protocol at different body mass index levels
Contributor:
Elsholtz, Fabian Henry Jürgen;
Schaafs, Lars-Arne;
Köhlitz, Thorsten;
Hamm, Bernd;
Niehues, Stefan Markus
Description:
<jats:sec><jats:title>Background</jats:title><jats:p> Computed tomography (CT)-guided periradicular infiltration remains a frequent interventional procedure for treatment of low back pain. </jats:p></jats:sec><jats:sec><jats:title>Purpose</jats:title><jats:p> To present an interventional ultra-low-dose protocol for CT-guided periradicular infiltration therapy and assess its application at different body mass index (BMI) levels. </jats:p></jats:sec><jats:sec><jats:title>Material and Methods</jats:title><jats:p> Over a period of 14 months, 79 patients underwent 183 CT-guided interventions for single-site lumbar periradicular therapy using an ultra-low-dose protocol with a basic setup of 100 kV and 5 mAs. Procedures were performed via intermittent fluoroscopy. A retrospective review was performed to analyze the parameters tube current and tube voltage, dose-length product, and BMI. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> The interventional ultra-low-dose protocol allowed safe treatment of 91.1% of the patients without a need for adapting the protocol. In seven patients with a higher BMI (range, 31–38 kg/m<jats:sup>2</jats:sup>; mean, 34 kg/m<jats:sup>2</jats:sup>), the tube current had to be increased to retain sufficient image quality. Only patients with a BMI of 30 and higher showed a significant correlation between BMI and dose-length product ( P value = 0.02), resulting in a slightly increased dose ( P value = 0.002). </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> The protocol presented for the interventional part of CT-guided periradicular infiltration allows to safely treat patients with a median calculated effective dose of 0.045 mSv (converted from a dose-length-product of 2.26 mGy*cm). Patients with a BMI of 30 and higher required a higher calculated effective dose with just one patient slightly exceeding 0.1 mSv. </jats:p></jats:sec>