located and understand their importance in ensuring counts to the
correct spine level are correct.
3. Capture the best possible image
The biggest factor that contributes to surgeons counting to the wrong
vertebrae is the poor quality of intraoperative images. Some areas of
the spine, particularly the thoracic spine, are difficult to visualize and
access. It's hard to be confident you're in the right spot, even during
the perfect case. The reasons for this could be related to the patient's
body type or specific anatomy. The patient could be obese or have
abnormal pathology that makes it difficult to properly view the verte-
brae. If they have osteoporosis, for example, bones appear very light
on X-rays and are therefore hard to see on intraoperative images
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