https://doi.org/10.1140/epjs/s11734-026-02346-3
Regular Article
Evaluation of low-dose induced DSBs after minimally invasive vertebroplasty
1
Department of Radiobiology, National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
2
Department of Neurosurgery, University Hospital St. Ivan Rilski, Sofia, Bulgaria
a
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Received:
25
August
2025
Accepted:
24
April
2026
Published online:
7
May
2026
Abstract
Symptomatic vertebral fractures are common among the population and are associated with pain and obstruction of free movement of the individual. Vertebroplasty is a minimally invasive, fluoroscopically guided medical procedure widely used to treat these vertebral fractures. It involves the percutaneous injection of bone cement, typically polymethyl methacrylate, into the fractured vertebra to provide stabilization, alleviate pain, and restore structural integrity. However, fluoroscopy for real-time image guidance exposes patients to low doses of ionizing radiation. This study aimed to assess the extent of DNA damage by quantifying DNA double-strand breaks (DSBs) in peripheral blood mononuclear cells following low-dose irradiation in patients undergoing vertebroplasty. Blood samples were collected before and after the medical procedure. DNA damage was detected in lymphocytes using immunofluorescence microscopy, assessing the co-localization of γ-H2AX and 53BP1 DNA damage-repair proteins as markers of DSBs. No patient received more than a 100 mGy cumulative air kerma dose during fluoroscopy time. In the investigated group of 67 patients, a statistically significant increase in DSBs’ frequency was observed after vertebroplasty (p < 0.001) and this increase was not correlated with an increase in the dose received by the patient. Our findings indicate a significant rise in DNA damage in patients following vertebroplasty, despite the low radiation doses received during this routine medical procedure.
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© The Author(s), under exclusive licence to EDP Sciences, Springer-Verlag GmbH Germany, part of Springer Nature 2026
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
