Intraoperative Radiographs Essential for Avoiding Errors
These and other precautions can prevent neurosurgery at an incorrect site
FRIDAY, July 18 (HealthDay News) -- Intraoperative radiographs and other precautions are critical for preventing incorrect-site surgery among neurosurgeons, according to three letters to the editor published in the July issue of the Journal of Neurosurgery: Spine, in response to a previous report.
In one letter, Joshua M. Ammerman, M.D., and Matthew D. Ammerman, M.D., of George Washington University in Washington, D.C., recommend pre-incision radiographs for disease above the L5-S1 level and age greater than 55 years in spine surgery patients, as these were strong predictors of incorrect level exposure when based solely on intraoperative inspection of anatomical landmarks. They also recommend pre-incision "time-outs" before spine surgery.
In another letter, Ramesh Sahjpaul, M.D., of the University of British Columbia in Vancouver, Canada, called for the routine use of intraoperative imaging to prevent wrong-side craniotomy. He also described his group's "concluding time-out" to ensure all planned components of the surgery were completed. In a third letter, Claudio Irace, M.D., and colleagues at IGEA Hospital in Milan, Italy, describe their group's quality management techniques that have led to no incorrect-site surgeries in at least 1,400 cases.
"We agree that the incidence of incorrect-site surgeries in neurosurgical practice is very low; however, the effort to further minimize it must continue to characterize our daily work," Irace and colleagues conclude.