Outpatient Surgery Magazine features an article written by HSS spine surgeon Sheeraz Qureshi, MD, MBA, discussing imaging enhancements and culture changes that will help prevent wrong-site spine surgery errors.

Dr. Qureshi explained as most vertebrae anatomy looks the same, the only way to know you're at the correct spot is to find an anatomical landmark that looks different from the rest of the spine, and to count vertebrae until you reach the disc that needs treatment. Most spine surgeons make three localized counts to confirm the intended surgical site.

Dr. Qureshi noted the main culprit for wrong-site surgeries is a simple counting error made by the surgeon. To help prevent these mistakes, Dr. Qureshi suggested conducting three time outs during the three localization attempts - pre-incision, post-exposure and at the procedure’s completion – to ensure the correct vertebrae has been located and treated.

Additionally, he cited the biggest factor that contributes to surgeons counting to the wrong vertebrae is the poor quality of intraoperative images. Some areas of the spine, particularly the thoracic spine, are difficult to visualize and access, making it hard to be confident you're in the right spot even during the perfect case. The reasons for this could be related to the patient's body type or specific anatomy (e.g., an abnormal pathology that makes it difficult to properly view the vertebrae; or lack of adequate visualization is sometimes a technical issue). He recommends investing in surgical navigation technology, as it produces superior image quality that can further reduce the likelihood of wrong-site errors from occurring.

Dr. Qureshi concluded although advanced technologies can be invaluable in helping surgical teams prevent wrong-site surgery during spine cases, the most reproduceable solution is the localized time outs. 

Read the full article at Outpatientsurgery.net.