title: Wrong-level surgery: A unique problem in spine surgery.
abstract: BACKGROUND
  Even though a lot of effort has gone into preventing operating at the wrong site and wrong patient, wrong-level surgery is a unique problem in spine surgery.
  
  
  METHODS
  The current method to prevent wrong level spine surgery performed is mainly relied on intra-operative X-ray. Unfortunately, because of the unique features and anatomy of the spinal column, wrong level spine surgery still happens. There are situations that even with intraoperative X-ray, correct level still cannot be reliably identified.
  
  
  RESULTS
  Examples of patient whose surgery can easily be performed on the wrong level are illustrated. A protocol to prevent wrong-level spine surgery preformed is developed.
  
  
  CONCLUSIONS
  The consequence of wrong-level spine surgery not only generates another surgery of the intended level; it is usually also associated with lawsuit. Strictly following this protocol can prevent wrong-level spine surgery.
authors.affiliation: Department of Spine Center, Swedish Neuroscience Institute, 550 17 Ave., Suite 500, Seattle, WA 98122, USA.
authors.forename: John
authors.initials: J
authors.lastname: Hsiang