Wrong-level spine surgery: A multicenter retrospective study.

Area of Science:

• Neurosurgery
• Spine Surgery
• Patient Safety

Background:

• Wrong-level spine surgery is a rare but serious complication.
• It increases patient harm and legal risks.
• Adequate investigation into causes and prevention is lacking.

Purpose of the Study:

• To examine the causes of wrong-level spine surgeries.
• To identify preventive measures for wrong-level spine surgeries.

Main Methods:

• Analysis of 18 cases of wrong-level spine surgeries across 10 medical centers.
• Study of patient demographics, surgical details, surgeon experience, and anatomical variations.
• Survey of surgeons on methods used to confirm surgical levels preoperatively and intraoperatively.

Main Results:

• Wrong-level spine surgeries occurred more frequently in posterior thoracic surgery (p < 0.01).
• Anatomical variations and unfamiliarity with techniques were noted in some cases.
• Half of surgeons performing posterior thoracic laminectomies used preoperative markers without intraoperative fluoroscopy.

Conclusions:

• Posterior thoracic surgeries have a higher incidence of wrong-level events due to unique anatomical challenges.
• Difficulty in identifying vertebral levels in the thoracic spine poses a risk.
• Unfamiliarity with techniques and anatomical variations are significant risk factors.