• Chris Lindemann, Patrick Strube, Christian Fisahn, Alexander Hölzl, Sebastian Rohe, Mirco Sgroi, and Timo Zippelius.
• Orthopedic Department, Jena University Hospital, Campus Eisenberg, Eisenberg, Germany. Electronic address: c.lindemann@waldkliniken-eisenberg.de.
• World Neurosurg. 2023 Mar 1; 171: e24e30e24-e30.

ObjectiveThis retrospective cohort study investigated the radiation exposure and clinical efficiency of a new institutional low-dose protocol for computed tomography (CT)-guided lumbar periradicular infiltration (PRI).MethodsThis was a retrospective matched-pair comparison of patients undergoing single-level lumbar PRI therapy employing a new low-dose CT protocol consisting of a helical scan with reduced energy levels and tube current versus the institutional standard CT protocol. The following variables were collected: dose-length product for the planning step, interventional step, and total examination, number of CT guidance scans, examination time, and postprocedural improvement on the numerical rating scale for radicular pain.ResultsForty-five patients were allocated to each group. A sufficient radiation dose reduction of 30% during PRI was achieved with the low-dose protocol with a median dose-length product of 9.8 mGy∗cm compared to 32.9 mGy∗cm with the standard protocol (P < 0.001). No need for additional multiple scans during the interventional mode was observed in the low-dose group, resulting in a comparable procedure time between the groups. Furthermore, the short-term pain-reducing effect of PRI was comparable between the low-dose and standard protocols (median delta numerical rating scale = 4 in both groups).ConclusionsOur low-dose protocol with less tube voltage and lower electric current leads to less radiation exposure with the same safety and efficiency. In conclusion, every facility that performs CT-based procedures should check whether a further dose reduction is applicable to avoid stochastic radiation damage to the patient.Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

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