(HealthDay)—Most surgeons admit wrong-level localization during spinal surgery during their career, according to a study published in the May 1 issue of The Spine Journal.
Jillian E. Mayer, from the Mount Sinai School of Medicine in New York City, and colleagues distributed an online, eight-question survey to members of the North American Spine Society. The authors sought to determine the prevalence of wrong-level localization during spine surgery and to identify circumstances commonly associated with wrong-level surgery. One hundred seventy-three surgeons completed the survey.
The researchers found that the most commonly used anatomic landmark for localization of thoracic and lumbar surgeries was facet joint with corresponding pedicle (used by 67 and 59 percent, respectively), followed by the spinous process (49 and 52 percent, respectively). Over two-thirds of surgeons (68 percent) admitted to wrong-level localization during their careers, some of which were rectified intraoperatively. When the error occurred, 56 percent reported using plain radiographs and 44 percent used fluoroscopy. Failure to visualize known reference points, recognize unconventional spinal anatomy, and adequately visualize the level because of large body habitus were common sources of preoperative errors, while poor communication, failure to relocalize after exposure, and poor counting methods were common sources of intraoperative errors.
"There is no standard approach that will entirely eliminate these mistakes; however, using a localization time out and increasing awareness of common sources of error may help decrease the incidence of wrong-level spine surgery," the authors write.
Several authors disclosed financial ties to the medical device industry.
Explore further: Spine surgeons vary considerably in imaging practices
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(HealthDay)—Most surgeons admit wrong-level localization during spinal surgery during their career, according to a study published in the May 1 issue of The Spine Journal.
Jillian E. Mayer, from the Mount Sinai School of Medicine in New York City, and colleagues distributed an online, eight-question survey to members of the North American Spine Society. The authors sought to determine the prevalence of wrong-level localization during spine surgery and to identify circumstances commonly associated with wrong-level surgery. One hundred seventy-three surgeons completed the survey.
The researchers found that the most commonly used anatomic landmark for localization of thoracic and lumbar surgeries was facet joint with corresponding pedicle (used by 67 and 59 percent, respectively), followed by the spinous process (49 and 52 percent, respectively). Over two-thirds of surgeons (68 percent) admitted to wrong-level localization during their careers, some of which were rectified intraoperatively. When the error occurred, 56 percent reported using plain radiographs and 44 percent used fluoroscopy. Failure to visualize known reference points, recognize unconventional spinal anatomy, and adequately visualize the level because of large body habitus were common sources of preoperative errors, while poor communication, failure to relocalize after exposure, and poor counting methods were common sources of intraoperative errors.
"There is no standard approach that will entirely eliminate these mistakes; however, using a localization time out and increasing awareness of common sources of error may help decrease the incidence of wrong-level spine surgery," the authors write.
Several authors disclosed financial ties to the medical device industry.
Explore further: Spine surgeons vary considerably in imaging practices
More information: Abstract
Full Text (subscription or payment may be required)
Copyright © 2014 HealthDay. All rights reserved.
Medical Xpress on facebook
Related Stories
Spine surgeons vary considerably in imaging practices
Jun 22, 2013
(HealthDay)—Spinal surgeons show considerable variability in imaging practices for elective lumbar spine surgery, according to a study published in the June 15 issue of Spine.
Spondylolisthesis linked to spinous process fractures
Jun 02, 2012
(HealthDay) -- There is a strong association between degenerative spondylolisthesis and spinous process fracture in patients undergoing interspinous process spacer (IPS) surgery, according to a study published ...
Research studies highlight advantages and potential of computer-guided spinal surgery
Apr 03, 2014
In a series of research studies, Cedars-Sinai spinal surgeons show that a new method of computer-guided spine surgery is beneficial for spinal reconstruction and for treating complex tumors and degenerative spine problems, ...
Pre-op depression linked to narcotic use before spinal Sx
Dec 19, 2013
(HealthDay)—For patients undergoing spinal surgery for a structural lesion, preoperative depression and anxiety are associated with increased preoperative narcotic use, according to a study published in ...
Model can predict spine surgery complications
Jan 31, 2014
(HealthDay)—A new model can predict the risk of medical complications, including major complications, after spine surgery, according to a study published in the Feb. 1 issue of The Spine Journal.
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5 hours ago
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Studies offer insight on how to improve kidney and liver transplantation
9 hours ago
The quality of kidney and liver donations is fundamentally important for the longevity of transplants and the health of recipients. That's why it's critical to know which organs are suitable for transplantation, as well as ...
Applying lessons from NASA helps manage threats and errors in pediatric cardiac surgery
11 hours ago
All high-stakes industries that function at very high "6-sigma" safety levels have a pre-occupation with human error. The aviation industry epitomizes this concept; during the 1970s NASA and aviation researchers ...
Complications from kidney stone treatments are common and costly
12 hours ago
Despite their overall low risk, procedures to treat kidney stones lead to complications that require hospitalization or emergency care for one in seven patients, according to researchers at Duke Medicine.
Patients report high satisfaction with pain treatment
20 hours ago
An international research group with members from the University of Basel, several EU countries, Israel and the USA, analyzed patient satisfaction with pain treatment after surgery. The study based on an extensive multi-national ...
Laser-assisted drug delivery is evolving
Apr 27, 2014
(HealthDay)—Laser-assisted drug delivery can enhance the permeation of topically applied agents, according to a review published in the April issue of Lasers in Surgery and Medicine.
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