2. 1. Target Tape is adhered
to the patient in the
prone position
2. Perform an X-ray in the
OR with Target Tape
3. Remove the top layer
and mark the incision site
Remove Target Tape, prep
the skin and incise
4. Place metal markers
internally to check for
incising error
Spinal Procedure
Lumbar multi-site with OR X-ray
Decrease incision sizes by 50% 1
Conventional lumbar incisions can be
5 to 10 cm long. Studies have shown
that using a radiopaque guide for a
surface site correlation can reduce the
incision sizes to 3 cm.1
Use a larger, single plain X-ray
Target Tape can easily be used with
a large plain X-ray, which is simpler
and faster to view landmarks and
targets, as well as multiple sites,
compared to repeated C-arm images
that are usually 3x smaller. In
addition, the larger X-ray view can
correlate more clearly to the preop
MRI/CT to confirm the site.
Mitigate cancer risks 2
Reducing radiation, reduces
unnecessary risk to patients and
medical staff. Target Tape needs only
a single X-ray image, compared to the
repeated iterations of the current
fluoro/needle method.
Atypical anatomy may be
present in 38% of cases 3
Fluoro’s more limited view makes
catching anomalies more difficult.
Atypical anatomy can lead to in-
accurate correlation with landmarks. 4
Target Tape allows for faster and
easier checks with multiple landmarks
as redundancy.
Localizing is faster with a
grid compared to a needle
Save time by skipping
palpation, needles with
fluoro and taking extra
exposures
1. Tsai KJ, et al: Multiple parallel skin markers for minimal incision lumbar disc surgery; a technical note. BMC Musculoskeletal
Disorders 2004, 5:8.
2. Ashmore JP, et al: First analysis of mortality and occupational radiation exposure based on the National Dose Registry of Canada.
Am J Epidemiol 1998, 148(6)564-574.
3. Lindley et al: Unusual spine anatomy contributing to wrong level spine surgery. Patient Safety in Surgery 2011, 5:33.
4. Snider KT, et al: Palpatory accuracy of lumbar spinous processes using multiple bony landmarks. Journal of Manipulative and
Physiological Therapeutics 2011, 34:306-313.
3. Spinal Procedure
Imaging beforehand in radiology
1. Perform a plain X-ray
before the operation
with Target Tape applied
2. Skin markings act as
anchor points for re-
alignment of the grid
3. Compare the preop CT
or MRI to the new X-ray,
correlating the target to
the grid
4. Place a new Target
Tape, remove the top
layer and mark the
incision site
Eliminate palpation dependency
Palpation is only 60% accurate. 3
Needles used with fluoro localization
are dependent upon palpation for
placement. Inaccuracies may lead to
repeated punctures, extra X-rays, larger
incisions or even wrong-site surgery.
Localize using more detailed
preoperative X-ray images
Target Tape may be used in Radiology
to save time and reduce X-rays in the
OR as well as the burden to OR X-ray
technicians. Using Target Tape on a
preop CT could allow for direct and
clear correlation with the target.
Once the bone is exposed, a lateral
intraop radiograph can be used as a
final confirmation, minimizing risks
even further.
55% of spinal surgeons
have operated on the
wrong level 6
Wrong level spinal
lawsuits can be $60,000
to $1.5 million 5
5. Goodkin R, et al: Wrong Disc Space Level Surgery: Medicolegal Implications. Surg Neurol 2004, 61:323-342.
6. Mody MG, et al: The Prevalence of Wrong Level Surgery Among Spine Surgeons. Spine 2008, 33:194-198.
Studies Using Markers for Spine Localization
English PT, et al.: Technical Note: A simple method for skin/lesion localization. British Journal of Radiology 1994, 67:813-815.
Kim KD, et al.: Use of a radiopaque localizer grid to reduce radiation exposure. Annals of Surgical Innov and Research 2011, 5:6.
Surgeons have found
Target Tape especially
useful for localization
in thoracic and upper
lumbar regions.
4. C FED
4
3
2
6
7
8
4
3
2
6
7
8
B
BA
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C D E F G
BA C D E
1
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9
68W2-10 LARGE (spine, thorax)
Non-Sterile, 10 per box
6 x 8 in / 15 x 20 cm grid
1 in / 2.5 cm increments
F G
Target Tape Inc.
501 - 535 Thurlow St.
Vancouver, BC V6E 3L2
target-tape.com
Reduce dependency on radiologist site-
marking with added imaging, $400 10
Eliminating the unnecessary iterations
of OR X-ray saves the estimated time-
equivalent of $585
Localizing in the OR with fluoroscopy can
take over 12 minutes,8
more so in difficult
thoracic cases. Using plain X-rays with
standard techniques could take even longer,
with the repeated iterations of each exposure.
Wrong level spinal surgery can result
in multi-million dollar lawsuits 5
Spinal surgeons are the most likely to
perform a wrong-site surgery.11
55% of spinal
surgeons have operated on the wrong level.6
Because reporting these events to the Joint
Commission is voluntary, it could be that only
10% of actual cases are reported.12
Target
Tape can increase accuracy and reduce risks.
®
Sterile and smaller
versions are upcoming.
Traditional
Target Tape
OR Cost/Min
Cost Savings
12 minutes
3 minutes*
$65 9
$585
OR Time Savings 9 minutes
Increase the number of procedures
Invest in more efficient technology
Standardize best practices
Provincial Action Plan 7
Clinically effective and economically efficient,
benefiting the patient, surgeon and budget.
Fast. Easy. Accurate.
Code Description
Phone: +1 778 868 1544
Made in the U.S.A.
Patent Pending
* Estimated time for single X-ray Target Tape localization
7. Ontario Continues to Lead Canada in Wait Times. (2012, Dec 5). Retrieved November 2014 from
http://news.ontario.ca/mohltc/en/2012/12/ontario-continues-to-lead-canada-in-wait-times.html
8. Upadhyaya CD, et al: Avoidance of wrong-level thoracic spine surgery: intraoperative localization with preoperative percutaneous
fiducial screw placement. J Neurosurg Spine 2012, 16:280–284.
9. Bozic KJ, et al: Hospital resource utilization for primary and revision total hip arthroplasty. J Bone Joint Surg Am.
2005;87(3):570-576.
10. CT Scan. (2012, March 1). Retrieved November 2014, from
http://www.david-cummings.com/documents/canadian_hospital_rates.html.
11. JA Michelle, et al: The Occurrence of Wrong-Site Surgery Self-Reported by Candidates for Certification by the American Board of
Orthopaedic Surgery. J Bone Joint Surg Am, 2012 Jan 04;94(1):e2.
12. Croteau R. Promoting correct site surgery: are you up to date? AORN Connections. 2003;1(12):1–4.
Due to the limited view of fluoroscopy,
surgeons can request a radiologist to perform
an extra CT/X-ray scan to mark the spinal site
beforehand, especially in difficult regions
beyond the lower lumbar. Target Tape requires
a single plain X-ray in the OR, which reduces
dependency on the radiologist and an extra CT
/Xray scan, potentially lowering wait times for
patients.
