{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T05:49:35Z","timestamp":1770616175221,"version":"3.49.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,2]]},"abstract":"\n Study Design:<\/jats:title>\n A technical report.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n The aim of the present study was to present an improvement on localization techniques employed for use in the thoracic spine using sterile spinal needles docked on the transverse process of each vertebra, which can be performed in both percutaneous and open spinal procedures.<\/jats:p>\n <\/jats:sec>\n \n Summary of Background Data:<\/jats:title>\n Wrong-level surgery may have momentous clinical and emotional implications for a patient and surgeon. It is reported that one in every 2 spine surgeons will operate on the wrong level during his or her career. Correctly localizing the specific thoracic level remains a significant challenge during spine surgery.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Fluoroscopic anteroposterior and lateral views were obtained starting in the lower lumbar spine, and an 18-G spinal needle was placed in the transverse process of L3 counting up from the sacrum and also at T12. The fluoroscopy was then moved cephalad and counting from the spinal needle at T12, the other spinal needles were placed at the targeted operating thoracic vertebrae. Once this was done, we were able to accurately determine the thoracic levels for surgical intervention.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Using this technique, the markers were kept in place even after the incisions were made. This prevented us from losing our location in the thoracic spine. Correctly placed instrumentation was made evident with postoperative imaging.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n We have described the successful use of a new technique using spinal needles docked against transverse processes to correctly and reliably identify thoracic levels before instrumentation. The technique was reproducible in both open surgeries and for a percutaneous procedure. This technique maintains the correct spinal level during an open procedure. We posit that wrong-level thoracic spine surgery may be preventable.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bsd.0b013e3182a35762","type":"journal-article","created":{"date-parts":[[2013,7,27]],"date-time":"2013-07-27T01:12:15Z","timestamp":1374887535000},"page":"E54-E58","source":"Crossref","is-referenced-by-count":15,"title":["Avoidance of Wrong-level Thoracic Spine Surgery Using Sterile Spinal Needles"],"prefix":"10.1097","volume":"30","author":[{"given":"Kingsley R.","family":"Chin","sequence":"first","affiliation":[{"name":"Department of Clinical Biomedical Sciences, Charles E. Schmidt College of Medicine at Florida Atlantic University"},{"name":"Institute for Modern and Innovative Surgery (iMIS)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Seale","sequence":"additional","affiliation":[{"name":"Institute for Modern and Innovative Surgery (iMIS)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Cumming","sequence":"additional","affiliation":[{"name":"LES Society, Fort Lauderdale, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20230831","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/j.spinee.2007.06.005","article-title":"Improving accuracy and reducing errors in spinal surgery\u2014a new technique for thoracolumbar-level localization using computer-assisted image guidance","volume":"8","author":"Nowitzke","year":"2008","journal-title":"Spine J"},{"key":"R2-20230831","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1016\/j.surneu.2005.09.026","article-title":"Malpractice issues in neurological surgery","volume":"65","author":"Fager","year":"2006","journal-title":"Surg Neurol"},{"key":"R3-20230831","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1097\/BRS.0b013e31816043d1","article-title":"The prevalence of wrong level surgery among spine surgeons","volume":"33","author":"Mody","year":"2008","journal-title":"Spine"},{"key":"R4-20230831","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.1097\/BRS.0b013e3181d833ac","article-title":"Avoiding wrong site surgery: a systematic review","volume":"35","author":"Devine","year":"2010","journal-title":"Spine"},{"key":"R5-20230831","doi-asserted-by":"crossref","first-page":"280","DOI":"10.3171\/2011.3.SPINE10445","article-title":"Avoidance of wrong-level thoracic spine surgery: intraoperative localization with preoperative percutaneous fiducial screw placement","volume":"16","author":"Upadhyaya","year":"2012","journal-title":"J Neurosurg Spine"},{"key":"R6-20230831","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1007\/s11999-010-1603-2","article-title":"Is intraoperative CT of posterior cervical spine instrumentation cost-effective and does it reduce complications","volume":"469","author":"Hecht","year":"2011","journal-title":"Clin Orthop Relat Res"},{"key":"R7-20230831","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1097\/BRS.0b013e3181c90bdf","article-title":"Percutaneous placement of radiopaque markers at the pedicle of interest for preoperative localization of thoracic spine level","volume":"35","author":"Binning","year":"2010","journal-title":"Spine"},{"key":"R8-20230831","first-page":"175","article-title":"Image-guided surgery: applications to the cervical and thoracic spine and a review of the first 120 procedures","volume":"92","author":"Bolger","year":"2000","journal-title":"J Neurosurg"},{"key":"R9-20230831","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1259\/0007-1285-67-800-813","article-title":"Technical note: a simple method for skin\/lesion localization using magnetic resonance imaging","volume":"67","author":"English","year":"1994","journal-title":"Br J Radiol"},{"key":"R10-20230831","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1097\/00007632-199601010-00027","article-title":"Intraoperative transligamentous ultrasound in the evaluation of thoracic intraspinal disease","volume":"21","author":"Henegar","year":"1996","journal-title":"Spine (Phila PA 1976)"},{"key":"R11-20230831","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1097\/BSD.0b013e3181493194","article-title":"Intraoperative localization of thoracic spine level with preoperative percutaneous placement of intravertebral polymethylmethacrylate","volume":"21","author":"Hsu","year":"2008","journal-title":"J Spinal Disord Tech"},{"key":"R12-20230831","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1007\/s00586-009-0946-4","article-title":"Preoperative coil marking to facilitate intraoperative localization of spinal dural arteriovenous fistulas","volume":"18","author":"Marquardt","year":"2009","journal-title":"Eur Spine J"},{"key":"R13-20230831","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1080\/02688690500089209","article-title":"Spinous process marking: a reliable method for preoperative surface localization of intradural lesions of the high thoracic spine","volume":"19","author":"Paolini","year":"2005","journal-title":"Br J Neurosurg"},{"key":"R14-20230831","first-page":"163","article-title":"A method for identification of vertebral level","volume":"68","author":"Redfern","year":"1986","journal-title":"Ann R Coll Surg Engl"},{"key":"R15-20230831","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/S0090-3019(02)00863-7","article-title":"Skin markers for surgical planning for intradural lesions of the thoracic spine. 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