The survey was distributed to North American Spine Society members, and findings are the result of 173 responses.
Survey findings include:
• Sixty-eight percent of surgeons admitted to wrong-level localization during their careers. Fifty-six percent of these surgeons reported using plain radiographs and 44 percent used fluoroscopy for procedures in which the errors occurred.
• Fluoroscopy was the most commonly used spine imaging technique overall, and 89 percent of surgeons reported using it for thoracic surgeries, while 86 percent reported using it for lumbar surgeries.
• The facet joint with corresponding pedicle was the most commonly used anatomic landmark for localization of thoracic and lumbar surgeries, with 57 percent of surgeons using it for thoracic surgeries and 59 percent using it for lumbar surgeries.
According to the survey, common sources of preoperative errors included:
• Failure to visualize known reference points
• Failure to recognize unconventional spinal anatomy
• Failure to adequately visualize the level in overweight or obese patients
Also, common sources of intraoperative errors included:
• Poor communication
• Failure to relocalize after exposure
• Poor counting methods
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