• Pain Med · Jul 2017

    Is There a Relationship Between Body Mass Index and Fluoroscopy Time During Cervical Interlaminar Epidural Steroid Injections?

    • Zachary L McCormick, Ryan Mattie, Ali Ebrahimi, David T Lee, Austin Marcolina, Joel Press, D J Kennedy, Matthew Smuck, David R Walega, and Daniel Cushman.
    • Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.
    • Pain Med. 2017 Jul 1; 18 (7): 1326-1333.

    BackgroundThe challenge of obtaining medical imaging in individuals with higher body mass index (BMI) is described, but there is minimal data regarding the relationship between BMI and fluoroscopy time during cervical interlaminar epidural steroid injection (CIESI).ObjectiveTo determine the relationship between BMI and fluoroscopy time during CIESI.MethodsRetrospective cohort study of patients who underwent fluoroscopically guided CIESI between January 2014 and February 2015 at an academic pain medicine center. Fluoroscopy time data were collected. Comparisons based on analysis of variance were made between patients with normal (<25.0 kg/m 2 ), overweight (25.0-29.9 kg/m 2 ), and obese (≥30.0 kg/m 2 ) BMI.ResultsOf 399 procedure encounters, 366 had documented BMI and fluoroscopy time data and were included for analysis. Mean age (± SD) in this cohort was 53 ± 13 years, including 189 females (52%) and 205 first-time injections. Mean fluoroscopy time for all injections was 18 ± 10 seconds. Separated by categorical BMI class, the mean fluoroscopy time was 18 ± 9 seconds for normal weight patients, 17 ± 10 seconds for overweight patients, and 20 ± 11 seconds for obese patients, respectively. Post hoc analysis showed that fluoroscopy time was significantly longer only in obese compared with overweight patients ( P  = 0.02). Trainee involvement and first-time vs repeat injection did not significantly alter fluoroscopy time ( P  = 0.17 and P  = 0.12, respectively).ConclusionsThe findings of this study indicate that BMI does not appear to have a clinically significant impact on fluoroscopy time during cervical interlaminar epidural steroid injection procedures. Future study is needed to directly quantify radiation exposure in patients and practitioners, as well as the associated health risk.© 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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