Article

The impact of patient body mass index (BMI) on image-guided spine
interventions remains unknown. Higher BMI is known to complicate the acquisition
of radiographic images. Therefore it can be hypothesized that the patient's body
habitus can influence the delivery of a spinal injection. OBJECTIVE: To quantify
the impact of patient BMI on the length of fluoroscopy and procedure times during
spine interventions. DESIGN: Secondary analysis of 2 prospective observational
studies. SETTING: All injections were performed in an outpatient university
setting. PARTICIPANTS: A total of 209 patients in whom spine injections were
performed (99 women), with a mean age of 54.6 years. METHODS: The fluoroscopy
times for 202 participants and total procedure times for 137 participants were
recorded. Additional participant characteristics, including age, gender, BMI, and
actual procedures performed, also were collected.
Analysis of covariance and
linear and nonlinear model analysis were performed to assess the effect of BMI on
fluoroscopy and procedure times. MAIN OUTCOME MEASUREMENTS: Fluoroscopy time and
procedure duration times. RESULTS: Participants had a mean age of 54.6 years, 51%
were men, and 77% (n = 155) were overweight (BMI >/=25). Participants received
the following interventions: 40 zygapophyseal joint injections, 33 medial branch
nerve blocks, 113 transforaminal epidural injections, and 16 combined
zygapophyseal joint injections and epidural injections.
Gender, procedure number,
and procedure type did not differ between groups. The overweight group
demonstrated a 30% increase in mean fluoroscopy time and a 35% increase in mean
procedure time. Controlling for other variables, we found that differences in
fluoroscopy time and procedure time were significant
(P = .032 and P = .031,
respectively) between the 2 groups. CONCLUSIONS: Significantly prolonged
procedure time and fluoroscopy time in overweight patients increase the risks
associated with spine interventions, not only to the patients but also to the
operating room staff exposed to ionizing radiation.
CI - Copyright (c) 2013 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS