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Factors predictive of topographical accuracy in spine level localization
Jin W Tee1,2,3, Joost Rutges1,2,4, Travis Marion1,2
1University of British Columbia, Vancouver, BC, Canada.
Journal of Spine Surgery (Hong Kong)
|April 25, 2017
Summary
Pre-operative spine level localization using anatomical landmarks is inaccurate in 60% of cases. Palpable spinal deformity and wider interspinous distances improve localization accuracy for spine surgery.
Area of Science:
- Spine surgery
- Surgical navigation
- Anatomical localization
Background:
- Pre-operative spine level localization using anatomical landmarks (T4-L2) is frequently inaccurate.
- Inaccuracy leads to wasted time, increased radiation, longer incisions, and wrong-level surgery.
- Factors influencing accuracy include BMI, deformity, and anatomical knowledge.
Purpose of the Study:
- To evaluate the accuracy of pre-operative spine level localization using anatomical landmarks.
- To identify factors predicting accurate localization in posterior spine surgery.
Main Methods:
- Prospective study of 30 patients undergoing posterior spine surgery (T4-L2).
- Spine levels marked using landmarks before Target Tape application and radiographic verification.
- Evaluated age, gender, BMI, deformity, interspinous distance (ISPD), and skin-to-spinous process distance.
Main Results:
- Localization accuracy using landmarks was only 40%.
- Pathology-related ISPDs >10 mm and palpable deformity correlated with successful localization.
- Poor localization was associated with ISPDs <10 mm.
Conclusions:
- Anatomical landmark-based spine level localization is unreliable for posterior approaches (T4-L2).
- Palpable spinal deformity is a key factor for accurate localization.
- Wider interspinous distances (>10 mm) aid in accurate landmark identification.
