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: Chikato Mannoji, Masao Koda, Takeo Furuya, Yuzuru Okamoto, Tamiyo Kon, Kazuhisa Takahashi, Masashi Yamazaki, Masazumi Murakami
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2014/398457
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author Chikato Mannoji
Masao Koda
Takeo Furuya
Yuzuru Okamoto
Tamiyo Kon
Kazuhisa Takahashi
Masashi Yamazaki
Masazumi Murakami
author_facet Chikato Mannoji
Masao Koda
Takeo Furuya
Yuzuru Okamoto
Tamiyo Kon
Kazuhisa Takahashi
Masashi Yamazaki
Masazumi Murakami
author_sort Chikato Mannoji
collection DOAJ
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.
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institution OA Journals
issn 2090-6749
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publishDate 2014-01-01
publisher Wiley
record_format Article
series Case Reports in Orthopedics
spelling doaj-art-cb36ad34737842e99ef1946fc939cec72025-08-20T02:19:48ZengWileyCase Reports in Orthopedics2090-67492090-67572014-01-01201410.1155/2014/398457398457Radiograms Obtained during Anterior Cervical Decompression and Fusion Can Mislead Surgeons into Performing Surgery at the Wrong LevelChikato Mannoji0Masao Koda1Takeo Furuya2Yuzuru Okamoto3Tamiyo Kon4Kazuhisa Takahashi5Masashi Yamazaki6Masazumi Murakami7Department of Orthopaedic Surgery, Chiba Aoba Municipal Hospital, Aobacho 1273-2, Chuo-ku, Chiba 260-0852, JapanDepartment of Orthopaedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, JapanDepartment of Orthopaedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, JapanDepartment of Orthopaedic Surgery, Chiba Aoba Municipal Hospital, Aobacho 1273-2, Chuo-ku, Chiba 260-0852, JapanDepartment of Orthopaedic Surgery, Chiba Aoba Municipal Hospital, Aobacho 1273-2, Chuo-ku, Chiba 260-0852, JapanDepartment of Orthopaedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, JapanDepartment of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, JapanDepartment of Orthopaedic Surgery, Chiba Aoba Municipal Hospital, Aobacho 1273-2, Chuo-ku, Chiba 260-0852, JapanA 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.http://dx.doi.org/10.1155/2014/398457
spellingShingle Chikato Mannoji
Masao Koda
Takeo Furuya
Yuzuru Okamoto
Tamiyo Kon
Kazuhisa Takahashi
Masashi Yamazaki
Masazumi Murakami
Radiograms Obtained during Anterior Cervical Decompression and Fusion Can Mislead Surgeons into Performing Surgery at the Wrong Level
Case Reports in Orthopedics
title 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_short 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
url http://dx.doi.org/10.1155/2014/398457
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