Fiducial marker placement for intraoperative spine localization

In recent years, there has been a great increase in the number of cases of image-guided fiducial marker placement for the purposes of stereotactic radiosurgery. At the authors' parent institution, a tertiary referral academic medical center, the placement of fiducial markers has also been used for the purposes of localization before spine surgery. Given the reported prevalence of "wrong-site" surgical intervention documented in the medical literature, particularly involving spinal surgery, the neurosurgical department at the authors' institution has requested the expertise of interventional radiology for assistance in preoperative spine localization. Therefore, there are medicolegal, medical cost, and patient care implications of image-guided fiducial marker placement.