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Wrong-Level Spine Surgery: Introduction of a Protocol for Avoidance of This Complication – Lumbar Fusion

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This article discusses the issue of wrong-level spine surgery, which is when a surgery is performed on the wrong vertebral level. Although protocols have been developed to prevent this serious complication, it continues to occur. The article describes a case of a 44-year-old woman who underwent surgery at the wrong level, leading to the development of a new protocol that includes a Spine Level Safety Checklist. Since implementing this protocol, the incidence of wrong-level spine surgery at the author’s institution has significantly decreased. The article recommends the adoption of this protocol by other centers to reduce the occurrence of this complication

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best rated spinal centre on Harley Street UK

Published article

Wrong-level spine surgery, in which an operation is performed at a vertebral level different from the intended one, is a rare but serious complication with wide-ranging medical and legal effects. Although many protocols have been developed to prevent such a serious unfavorable event, the problem has not yet been eliminated. Research into the effectiveness of strategies to prevent wrong-level spine surgery is lacking. Herein, we describe a case of 44-year-old woman presented with neck pain and…

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Acta Neurochir Suppl. 2023;130:179-184. doi: 10.1007/978-3-030-12887-6_21.ABSTRACTWrong-level spine surgery, in which an operation is performed at a vertebral level different from the intended one, is a rare but serious complication with wide-ranging medical and legal effects. Although many protocols have been developed to prevent such a serious unfavorable event, the problem has not yet been eliminated.,

Acta Neurochir Suppl. 2023;130:179-184. doi: 10.1007/978-3-030-12887-6_21.

ABSTRACT

Wrong-level spine surgery, in which an operation is performed at a vertebral level different from the intended one, is a rare but serious complication with wide-ranging medical and legal effects. Although many protocols have been developed to prevent such a serious unfavorable event, the problem has not yet been eliminated. Research into the effectiveness of strategies to prevent wrong-level spine surgery is lacking. Herein, we describe a case of 44-year-old woman presented with neck pain and bilateral upper extremity weakness and numbness. Magnetic resonance imaging showed C5/6 and C6/7 disc herniations with spinal cord compression. The patient underwent anterior cervical discectomy and fusion; however, at the conclusion of the surgery, intraoperative radiographs showed that it was accomplished at C4/5 and C5/6-one level above the intended level. On the basis of this case and similar ones, a new protocol was developed that included implementation of a Spine Level Safety Checklist to document the reference point, the landmark, and the level of exposure that is marked on the intraoperative radiograph. Since implementation of this protocol, the incidence of wrong-level spine surgery at the senior author’s institution has decreased from 4/7000 to 0/11,200. Adoption of this protocol by other centers is thus recommended to reduce the incidence of such complication.

PMID:37548737 | DOI:10.1007/978-3-030-12887-6_21

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Wrong-Level Spine Surgery: Introduction of a Protocol for Avoidance of This Complication

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Acta Neurochir Suppl. 2023;130:179-184. doi: 10.1007/978-3-030-12887-6_21.ABSTRACTWrong-level spine surgery, in which an operation is performed at a vertebral level different from the intended one, is a rare but serious complication with wide-ranging medical and legal effects. Although many protocols have been developed to prevent such a serious unfavorable event, the problem has not yet been eliminated.

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