The Devil is in the Details-Near-Miss Wrong-Level Thoracic Spine Surgery Despite Robotic Navigation: A Case Report.

CASE: A 67-year-old woman who presented with left-sided upper back pain, upper trunk paresthesia, and CT-identified left neural foraminal stenosis at T7 to T8 was planned for posterior spinal fusion and decompression using a robotic system. T7 to T8 was labelled with manual sacral counting. T7 to T8 level was registered robotically, but the arm was sent to the T5 to T6 level. T7 to T12 was re-registered, and the robot successfully targeted the correct site.

CONCLUSION

Technology is still fraught with error and is still in its nascency. It is important to use traditional methods with intraoperative verification to prevent errors in wrong-level thoracic spinal surgery.