Radiograms Obtained during Anterior Cervical Decompression and Fusion Can Mislead Surgeons into Performing Surgery at the Wrong Level

A 68-year-old woman who suffered from C5 nerve palsy because of a C4-5 disc herniation was referred to our hospital. We conducted anterior cervical decompression and fusion (ACDF) at the C4-5 level. An intraoperative radiogram obtained after exposure of the vertebrae showed that the level at which w...

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Main Authors:	Mannoji, Chikato, Koda, Masao, Furuya, Takeo, Okamoto, Yuzuru, Kon, Tamiyo, Takahashi, Kazuhisa, Yamazaki, Masashi, Murakami, Masazumi
Format:	Online
Language:	English
Published:	Hindawi Publishing Corporation 2014
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216671/

id	pubmed-4216671
recordtype	oai_dc
spelling	pubmed-42166712014-11-10 Radiograms Obtained during Anterior Cervical Decompression and Fusion Can Mislead Surgeons into Performing Surgery at the Wrong Level Mannoji, Chikato Koda, Masao Furuya, Takeo Okamoto, Yuzuru Kon, Tamiyo Takahashi, Kazuhisa Yamazaki, Masashi Murakami, Masazumi Case Report A 68-year-old woman who suffered from C5 nerve palsy because of a C4-5 disc herniation was referred to our hospital. We conducted anterior cervical decompression and fusion (ACDF) at the C4-5 level. An intraoperative radiogram obtained after exposure of the vertebrae showed that the level at which we were going to perform surgery was exactly at the C4-5 level. After bone grafting and temporary plating, another radiogram was obtained to verify the correct placement of the plate and screws, and it appeared to show that the plate bridged the C5 and C6 vertebrae at the incorrect level. The surgeon was astonished and was about to begin decompression of the upper level. However, carefully double-checking the level with a C-arm image intensifier before additional decompression verified that the surgery was conducted correctly at C4-5. Cautiously double-checking the level of surgery with a C-arm image intensifier is recommended when intraoperative radiograms suggest surgery at the wrong level. Hindawi Publishing Corporation 2014 2014-10-16 /pmc/articles/PMC4216671/ /pubmed/25386376 http://dx.doi.org/10.1155/2014/398457 Text en Copyright © 2014 Chikato Mannoji et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Mannoji, Chikato Koda, Masao Furuya, Takeo Okamoto, Yuzuru Kon, Tamiyo Takahashi, Kazuhisa Yamazaki, Masashi Murakami, Masazumi
spellingShingle	Mannoji, Chikato Koda, Masao Furuya, Takeo Okamoto, Yuzuru Kon, Tamiyo Takahashi, Kazuhisa Yamazaki, Masashi Murakami, Masazumi Radiograms Obtained during Anterior Cervical Decompression and Fusion Can Mislead Surgeons into Performing Surgery at the Wrong Level
author_facet	Mannoji, Chikato Koda, Masao Furuya, Takeo Okamoto, Yuzuru Kon, Tamiyo Takahashi, Kazuhisa Yamazaki, Masashi Murakami, Masazumi
author_sort	Mannoji, Chikato
title	Radiograms Obtained during Anterior Cervical Decompression and Fusion Can Mislead Surgeons into Performing Surgery at the Wrong Level
title_short	Radiograms Obtained during Anterior Cervical Decompression and Fusion Can Mislead Surgeons into Performing Surgery at the Wrong Level
title_full	Radiograms Obtained during Anterior Cervical Decompression and Fusion Can Mislead Surgeons into Performing Surgery at the Wrong Level
title_fullStr	Radiograms Obtained during Anterior Cervical Decompression and Fusion Can Mislead Surgeons into Performing Surgery at the Wrong Level
title_full_unstemmed	Radiograms Obtained during Anterior Cervical Decompression and Fusion Can Mislead Surgeons into Performing Surgery at the Wrong Level
title_sort	radiograms obtained during anterior cervical decompression and fusion can mislead surgeons into performing surgery at the wrong level
description	A 68-year-old woman who suffered from C5 nerve palsy because of a C4-5 disc herniation was referred to our hospital. We conducted anterior cervical decompression and fusion (ACDF) at the C4-5 level. An intraoperative radiogram obtained after exposure of the vertebrae showed that the level at which we were going to perform surgery was exactly at the C4-5 level. After bone grafting and temporary plating, another radiogram was obtained to verify the correct placement of the plate and screws, and it appeared to show that the plate bridged the C5 and C6 vertebrae at the incorrect level. The surgeon was astonished and was about to begin decompression of the upper level. However, carefully double-checking the level with a C-arm image intensifier before additional decompression verified that the surgery was conducted correctly at C4-5. Cautiously double-checking the level of surgery with a C-arm image intensifier is recommended when intraoperative radiograms suggest surgery at the wrong level.
publisher	Hindawi Publishing Corporation
publishDate	2014
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216671/
_version_	1613151273561882624

Radiograms Obtained during Anterior Cervical Decompression and Fusion Can Mislead Surgeons into Performing Surgery at the Wrong Level

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