gms | German Medical Science

Objective: Kyphoplasty is an established method to treat osteoporotic spine fractures. In a prospective randomized study we compared two comercially available kyphoplasty systems (CDS Medtronic vs. Radiofrequency DFine) in regard of radiation exposure for the examiner during treatment.

Method: From April 2013 to March 2014 we treated 40 patients with osteoporotic spine fractures of the thoraco-lumbar region in a randomized fashion with either one of the systems. Patients were equally distributed in regard of age, levels of fracture and intervention, as well as BMI and pain (VAS). During the intervention we documented the time and radiation dosis for each procedural stepp. All interventions were performed by one single experienced physician. Radiation dosis was measured by TCD chips. During cement application the CDS system allows a maximum distance of 1,1 m and the radiofrequency-system of 2,5 m between examiner and radiation source. Dosimetry was conducted by the LPS Berlin (Landesamt für Personendosimetrie und Strahlenschutz).

Results: The DFine system allows a monopedicular approach. Compared to the Medtronic system (bipedicular approach) a reduction of radiation time of 50% was documented. The lense dosis for the examiner was reduced by 80% using radiofrequency compared to CDS. The dosis for the right hand was reduced by 83% and for the left hand by 86%. Clinical results (reduction of pain utilizing the VAS, mobility, complication rate, length of hospital stay) were identical in both groups.

Conclusions: Radiation exposure is significantly reduced utilizing the radiofrequency system. The monopedicular approach allows shortening of the entire procedural time. The larger distance from the radiation source contributes further to a reduction of radiation, meanwhile achieving the same clinical results.