The 'nightmare' of wrong level in spine surgery: a critical appraisal

Patient Safety in Surgery

Volumn 6, Issue 1, 2012, Pages

  Irace, Claudio ^a   Usai, Susanna ^b  

^a Hospital IGEA   (Italy)

^b DEPARTMENT OF NEUROSURGERY   (Italy)

Author keywords

Discectomy; Incorrect site surgery; Interspinous device; IRACE method; Wrong level; Wrong level spine surgery

Indexed keywords

ACCURACY; ATTENTION; HUMAN; INTRAOPERATIVE PERIOD; LETTER; MICRODISCECTOMY; NEUROLOGIST; ORTHOPEDIC SURGERY; PREOPERATIVE PERIOD; RADIOLOGIST; SPINE DISEASE; SPINE SURGERY; SURGICAL APPROACH; SURGICAL TECHNIQUE; TEAMWORK; THORAX PAIN;

EID: 84867213999     PISSN: None     EISSN: 17549493     Source Type: Journal    
DOI: 10.1186/1754-9493-6-14     Document Type: Letter

References (8)

1. Lindley EM, et al. Unusual spine anatomy contributing to wrong level spine surgery: a case report and recommendations for decreasing the risk of preventable 'never events'. Patient Safety in Surgery 2011, 5:33. 10.1186/1754-9493-5-33, 3259034, 22168745.
2. Wong DA, Watters WC. To err is human: quality and safety issues in spine care. Spine 2007, 32(Suppl 11):S2-S8.
3. Joint Commission on the Accreditation of Healthcare Organizations (USA): Universal Protocol 2004, http://www.jointcommission.org/PatientSafety/NationalPatientSafety-Goals/04_npsgs.htm.
4. Jhawar BS, Mitsis D, Duggal N. Wrong-sided and wrong-level neurosurgery: a national survey. J Neurosurg Spine 2007, 7:467-472. 10.3171/SPI-07/11/467, 17977186.
5. Irace C, Corona C. How to avoid wrong-level and wrong-side errors in lumbar microdiscectomy. J Neurosurg Spine 2010, 12:660-665. 10.3171/2009.12.SPINE09627, 20515352.
6. Irace C, Giannachi L, Usai S, Corona C. Wrong-sided surgery. J Neurosurg Spine 2008, 9:107-108. letter, 10.3171/SPI/2008/9/7/107, 18590423.
7. Stahel PF, Sabel AL, Victoroff MS, et al. Wrong site and wrong patient procedures in the Universal Protocol era. Analysis of a prospective database of physicians self-reported occurrences. Arch Surg 2010, 145:978-984. 10.1001/archsurg.2010.185, 20956767.
8. Matsumoto M, Hasegawa T, Ito M, et al. Incidence of complications associated with spinal endoscopic surgery: nationwide survey in 2007 by the Committee on Spinal Endoscopic Surgical Skill Qualification of Japanese Orthopaedic Association. J Orthop Sci 2010, 15:92-96. 10.1007/s00776-009-1428-6, 20151257.