Bakır Mesut, Rumeli Şebnem, Ertargın Mehmet, Teker Nurettin, Azizoğlu Mustafa, Gazioğlu Türkyılmaz Gülçin
Division of Pain Medicine, Department of Anesthesiology and Reanimation, Faculty of Medicine, Mersin University, Mersin 33343, Turkey.
Department of Anesthesiology and Reanimation, Faculty of Medicine, Mersin University, Mersin 33343, Turkey.
Life (Basel). 2024 Sep 19;14(9):1179. doi: 10.3390/life14091179.
Chronic lumbar facet pain is commonly treated with fluoroscopy-guided facet medial branch blocks (FMBBs). However, the associated radiation exposure of both patients and clinicians is a growing concern. This study aimed to compare radiation doses and fluoroscopy times between two techniques, i.e., oblique and posterior-anterior (PA) fluoroscopic approaches, while also examining the impact of physician experience on these metrics. A retrospective analysis was conducted on 180 patients treated at Mersin University Hospital Pain Clinic between January and July 2024. Patients were divided into two groups: 90 received the oblique technique (Group O) and 90 received the AP technique (Group A). Radiation dose and fluoroscopy time data were collected for each patient. The AP technique was associated with significantly lower radiation doses (mean 66 mGy) and shorter fluoroscopy times (mean 28 s) compared to the oblique technique (mean radiation dose of 109 mGy and fluoroscopy time of 46 s) ( < 0.001). Physician experience also influenced these outcomes, with more experienced physicians consistently using less radiation. The AP technique should be considered for FMBBs, as it reduces radiation exposure while maintaining procedural efficiency, highlighting the importance of experience in optimizing outcomes.
慢性腰椎小关节疼痛通常采用透视引导下的小关节内侧支阻滞（FMBB）进行治疗。然而，患者和临床医生所面临的相关辐射暴露问题日益受到关注。本研究旨在比较两种技术，即斜位透视和前后位（PA）透视方法之间的辐射剂量和透视时间，同时研究医生经验对这些指标的影响。对2024年1月至7月在梅尔辛大学医院疼痛诊所接受治疗的180例患者进行了回顾性分析。患者分为两组：90例接受斜位技术（O组），90例接受前后位技术（A组）。收集了每位患者的辐射剂量和透视时间数据。与斜位技术（平均辐射剂量109 mGy，透视时间46秒）相比，前后位技术的辐射剂量显著更低（平均66 mGy），透视时间更短（平均28秒）（<0.001）。医生经验也影响了这些结果，经验更丰富的医生使用的辐射量始终较少。FMBB应考虑采用前后位技术，因为它在保持操作效率的同时减少了辐射暴露，突出了经验在优化结果方面的重要性。
