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Balraj S. Jhawar

T o T he R eadership : We thank Dr. Claudio Irace and colleagues for pointing out errors in the abstract of our paper, “Wrong-sided and wrong-level neurosurgery: a national survey” (J Neurosurg Spine 7:467–472, November, 2007). The correct rates of incorrect site surgery for lumbar and cervical discectomy are 12.8 and 7.6, respectively, per 10,000 cases, not 4.5 and 6.8 as stated in our abstract. The rate of incorrect site surgery for craniotomy should be 2.0 per 10,000 surgeries, not 2.2 as stated in our abstract. The data in the body of our paper

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Balraj S. Jhawar, Demytra Mitsis, and Neil Duggal

the wrong level.” Before administering the survey, we were concerned that the event rate for ICSS would be low. To address this possibility, we increased the event horizon by asking participants also to report the number of ICSS events that occurred during the previous 5 years, as well as during the entire period they had been in independent practice. We recognized that these estimates would not be as reliable or as valid as our 1-year estimates. Incorrect-Site Surgery Event Rate To estimate the rate of ICSSs, we first determined the total number of

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Michael G. Fehlings

overall intraoperative complication incidence of 3.3% (23 of 700 procedures). The importance of tracking adverse events or errors is clear when one considers that most do not lead to complications and hence would not be flagged without a high degree of vigilance. In their paper in this issue of the Journal of Neurosurgery , Jhawar et al. emphasize the need for rigorous protocols to minimize perioperative error in neurosurgery. These authors used a survey of Canadian neurosurgeons to determine the incidence and possible determinants of incorrect-site surgery (ICSS) as