Introducing Interlaminar Full-Endoscopic Lumbar Diskectomy: A Critical Analysis of Complications, Recurrence Rates, and Outcome in View of Two Spinal Surgeons' Learning Curves.
Détails
ID Serval
serval:BIB_E832AF73EDE5
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Introducing Interlaminar Full-Endoscopic Lumbar Diskectomy: A Critical Analysis of Complications, Recurrence Rates, and Outcome in View of Two Spinal Surgeons' Learning Curves.
Périodique
Journal of neurological surgery. Part A, Central European neurosurgery
ISSN
2193-6323 (Electronic)
ISSN-L
2193-6315
Statut éditorial
Publié
Date de publication
09/2016
Peer-reviewed
Oui
Volume
77
Numéro
5
Pages
406-415
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
Background and Study Objective Interlaminar full-endoscopic diskectomy is a minimally invasive surgical alternative to microdiskectomy for the treatment of lumbar disk herniation. The authors analyze their surgical results and learning curves during and after the introductory phase of this surgical technique. Patients and Methods We present a case review of 76 patients operated on using interlaminar full-endoscopic diskectomy. We retrospectively analyzed two spinal surgeons' learning curves in terms of operation time with respect to intraoperative blood loss, conversion rates, complications, infections, length of hospitalization, need for rehabilitation, recurrence rates, pain intensity, and opioid use. Patients' functional status and Health-related Quality of Life were assessed by follow-up questionnaires for 47 patients, using the North American Spine Society Score and the Short Form 12 in addition to long-term pain intensity, work capacity, and patient satisfaction with the operation. Results A steady state of the learning curve (operation time) of an experienced spinal surgeon was reached after 40 cases. Supervision by a more experienced surgeon can shorten the learning curve. The rate of conversions (10%), complications (5%), and recurrent lumbar disk herniations (28%) did not negatively affect the long-term outcome in patients operated on before and after the learning phase. Patient satisfaction was high. Conclusions The rate of conversions, complications, and recurrent lumbar disk herniations compared with microdiskectomy combined with the challenging learning curve should be considered before surgeons adopt this procedure. Supervision by an endoscopically experienced spinal surgeon during the introductory phase is highly advisable.
Mots-clé
Clinical Competence, Diskectomy/adverse effects, Diskectomy/education, Diskectomy/methods, Endoscopy/adverse effects, Endoscopy/education, Endoscopy/methods, Female, Humans, Incidence, Intervertebral Disc Displacement/surgery, Learning Curve, Lumbar Vertebrae/surgery, Male, Postoperative Complications/epidemiology, Recurrence, Retrospective Studies, Treatment Outcome
Pubmed
Web of science
Création de la notice
18/03/2024 20:56
Dernière modification de la notice
29/05/2024 7:11