Software pins down correct vertebra for surgery

According to Jeffrey Siewerdsen, Ph.D., a professor of biomedical engineering at Johns Hopkins, there are up to four incidents of “wrong-level” spine surgery per week in the US, a situation that can arise because the spine is made up of repeating elements that look alike.

However, results from its first clinical evaluation show that LevelCheck software achieves 100 per cent accuracy in 26 seconds. Details of the study will appear in the April 15 issue of the journal Spine.

Surgeons go to great lengths to get their procedures right, because mistakes are costly to patient health. They can result in pain, require follow-up surgeries, and create instability or degeneration of the spine, said to Jean-Paul Wolinsky, M.D., an associate professor of neurosurgery and oncology at Johns Hopkins and co-author of the study.

According to JHU, patients receive a diagnostic CT or MRI scan before a standard spinal operation that the surgeon uses to plan the surgery. Once the patient is on the operating table the surgeon typically counts down from the skull or up from the tailbone to determine which vertebra to operate on, often marking the patient’s anatomy with thin metal pins. These pins are visible in an X-ray image taken in the operating room to verify the target site. But the doctor’s initial planning on the preoperative scan is not visible in the X-ray image, leaving room for error, particularly when working on challenging cases exhibiting missing or extra vertebrae, a loss of anatomical landmarks from previous surgeries, or other anomalies.