{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T17:45:41Z","timestamp":1782582341076,"version":"3.54.5"},"reference-count":41,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Radiation exposure is a frequent drawback of spinal surgery, even if X-ray guidance plays a pivotal role in improving the accuracy and safety of spinal procedures. Consequently, radiation protection is essential to reduce potential negative biological effects. The aim of this study was to evaluate patients\u2019 radiation exposure, the radiation dose emission during fluoroscopy-guided ozone chemonucleolysis (OCN), and the potential role of patient characteristics. Methods: The radiation dose emission reports were retrospectively evaluated in patients who underwent single-level OCN for lumbar disc herniation. A generalized linear model (GLM) with a gamma distribution and log link function was used to assess the association between radiation emission and patients\u2019 characteristics such as age, sex, BMI, level of disc herniation, disc height, and site of disc herniation. Results: Two hundred and forty OCN cases were analyzed. A safe and low level of radiation exposure was registered during OCN. The median fluoroscopy time for OCN was 26.3 (19.4\u201335.9) seconds, the median radiation emission dose was 19.3 (13.2\u201327.3) mGy, and he median kerma area product (KAP) was 0.46 (0.33\u20130.68) mGy \u22c5 m2. The resulting KAP values were highly dependent on patient variables. In particular, sex, obesity, and residual disc height &lt; 50% significantly increased the measured KAP, while levels of disc herniations other than L5-S1 reduced the KAP values. Conclusions: The radiation exposure during OCN is low and quite similar to a simple discography. However, patient characteristics are significantly related to radiation exposure and should be carefully evaluated before planning OCN.<\/jats:p>","DOI":"10.3390\/jcm11247424","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T03:01:51Z","timestamp":1671073311000},"page":"7424","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Radiation Exposure during Fluoroscopy-Guided Ozone Chemonucleolysis for Lumbar Disc Herniation"],"prefix":"10.3390","volume":"11","author":[{"given":"Matteo Luigi Giuseppe","family":"Leoni","sequence":"first","affiliation":[{"name":"Unit of Interventional and Surgical Pain Management, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Vitali","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Micheli","sequence":"additional","affiliation":[{"name":"Unit of Interventional and Surgical Pain Management, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4321-6525","authenticated-orcid":false,"given":"Marco","family":"Mercieri","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Science and Translational Medicine, \u201cLa Sapienza\u201d University, 00189 Rome, Italy"},{"name":"Pain Therapy Unit, Sant\u2019Andrea Hospital, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3822-2923","authenticated-orcid":false,"given":"Giustino","family":"Varrassi","sequence":"additional","affiliation":[{"name":"Paolo Procacci Foundation, 00193 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Casale","sequence":"additional","affiliation":[{"name":"Opusmedica Persons, Care & Research-PC&R, 29121 Piacenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felice","family":"Occhigrossi","sequence":"additional","affiliation":[{"name":"Pain Therapy Department, San Giovanni Addolorata Hospital, 00184 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2073-1612","authenticated-orcid":false,"given":"Carlo","family":"Giordano","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/s12178-017-9441-4","article-title":"Lumbar Disc Herniation","volume":"10","author":"Amin","year":"2017","journal-title":"Curr. 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