Thoracic Spine Surgery: A New Technique to Avoid Operating on the Wrong Level (American Association of Neurological Surgeons (AANS))
It does not happen often, but nearly 50 percent of spine surgeons perform surgery on the wrong level of the spine sometime during their career. This is not surprising: a variety of factors make it difficult to localize a precise operative site in the thoracic spine, such as obesity, osteoporosis, and anatomical variations in the number of rib-bearing vertebra or the distance between traditional spinal landmarks. To avoid surgery on the wrong vertebral level, a new successful technique is proposed in an article in the Journal of Neurosurgery: Spine, available online Nov. 4, 2011, at http://www.thejns.org.
In their article, “Avoidance of wrong-level thoracic spine surgery: intraoperative localization with preoperative percutaneous fiducial screw placement,” Upadhyaya and colleagues describe a technique involving percutaneous placement of a fiducial screw in a specific thoracic vertebra to localize the appropriate operative site. Insertion of this minute screw is performed using computed tomography (CT) guidance and can be done preoperatively on a...
