Promising New Software Helps Improve Spine Surgery Safety

Because the spine is made up of repeating elements that look alike, surgeons can mistakenly operate on the wrong vertebra. To avoid this, Johns Hopkins researchers have developed a software program that works seamlessly with currently available procedures to assist a surgeon’s determination of which vertebra is which. Results from its first clinical evaluation show that the LevelCheck software achieves 100 percent accuracy in just 26 seconds. Details of the study will appear in the April 15 issue of the journal Spine.

“Wrong-level spine surgery is never meant to happen,” says Jeffrey Siewerdsen, Ph.D., a professor of biomedical engineering at Johns Hopkins and a member of the Armstrong Institute for Patient Safety and Quality. “But it happens nearly four times a week in the U.S.”

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, according to Jean-Paul Wolinsky, M.D., an associate professor of neurosurgery and oncology at Johns Hopkins and co-author of the study.

“We can’t eliminate the possibility of wrong-level surgeries,” says Wolinsky, “but this is an additional level of security—an independent check—that works quickly within our standard surgical workflow. Although LevelCheck in its current form requires a preoperative CT scan for most patients, the benefit is well worth it.”

In its early development, LevelCheck won an award from the North American Spine Society for Spine Technology of the Year. Work now underway by the research team includes a larger evaluation with images from 200 patients and testing in real time to measure its effects on time, workflow, accuracy and safety.

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