Sign, Mark & X-ray


SMaX Campaign for Prevention of Wrong-Site Spine Surgery & Procedures

Wrong-site surgery (WSS) and wrong-site procedures (i.e., injections, interventional procedures) are recognized risks within spine care due to the repetitive nature of the anatomy and distortion of landmarks due to prior surgery or deformity. To raise awareness and prevent these "never events," NASS developed the Sign, Mark & X-ray (SMaX) campaign as a multisociety effort in 2001. Safety protocols and tools continue to be updated by the committee. NASS encourages sharing of these resources and others linked below.

Other Resources

View for additional information on prevention of wrong-site spinal surgery and procedures, including the Universal Protocol Poster from The Joint Commision - a global driver of quality improvement and patient safety in healthcare.