Transforaminal epidural steroid injections: How BMI affects fluoroscopic time & radiation — 5 key notes


A new study published in The Spine Journal examines how the patient's body mass index affects fluoroscopic time and radiation dose for transforaminal epidural steroid injections.

The study authors examined 2,443 injections performed on 1,548 patients. All the patients underwent fluoroscopic lumbar transforaminal epidural steroid injections between February 2013 and March 2015.


There were 419 normal-weight patients, 572 overweight patients and 557 obese patients; there were 1,426 first-time injections and 1,017 repeat injections. A trainee was involved in just over half of the injections and 69 percent were unilateral injections. There were 26.4 percent that were single-level injections.


The researchers found:


1. The average fluoroscopy time was 30±17.5 seconds for all injections.


2. For the normal-weight patients, the average fluoroscopy time was 27.7±15.2 seconds; for overweight patients the average time was 30±21 seconds and for obese patients the average time was 32.2 ±15.1 seconds.


3. The average radiation dose was 2,164±1,484 mGy-cm2.


4. For the normal weight group, the average radiation does was 1,376±450; for overweight patients it's 1,911±653; and the obese patients is 3,029±640.


5. The researchers concluded the fluoroscopy radiation dose and fluoroscopy time during transforaminal epidural steroid injections increased in patients with higher BMI and older patients, but the trainee's presence didn't have an impact on fluoroscopy time.


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