ArticleClinical spine surgery2022
Time-demand, Radiation Exposure and Outcomes of Minimally Invasive Spine Surgery With the Use of Skin-Anchored Intraoperative Navigation: The Effect of the Learning Curve.
Article in Clinical spine surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Article
- Intraoperative Navigation in Cervical Spine Surgery.Journal of clinical medicine · 2026Review
- Comprehensive workflow with optical navigation in minimally invasive transforaminal lumbar interbody fusion: a retrospective study.Journal of orthopaedic surgery and research · 2025Review
- The Impact of Preoperative Sagittal Imbalance on Long-term Postoperative Outcomes Following Minimally Invasive Laminectomy.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2024Article
- Perspective: How can risks to patients be limited during spine surgeons' learning curves?Surgical neurology international · 2024Review
- Floor-Mounted Robotic Pedicle Screw Placement in Lumbar Spine Surgery: An Analysis of 1,050 Screws.Neurospine · 2023Article
- Step-by-step guide to robotic-guided minimally invasive transforaminal lumbar interbody fusion (MI-TLIF).Annals of translational medicine · 2023Article
- Comparing radiation dose of image-guided techniques in lumbar fusion surgery with pedicle screw insertion; A systematic review.North American Spine Society journal · 2023Review
- Practical answers to frequently asked questions in minimally invasive lumbar spine surgery.The spine journal : official journal of the North American Spine Society · 2023Review
- Advanced Technologies for Outpatient Lumbar Fusion: Barriers and Opportunities.International journal of spine surgery · 2022Article
- Surface Navigation and the Influence of Navigation on MIS Surgery.Global spine journal · 2022Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
STUDY
designRetrospective review.
objectiveThe aim was to evaluate the learning curve of skin-anchored intraoperative navigation (ION) for minimally invasive lumbar surgery. SUMMARY OF BACKGROUND DATA: ION is increasingly being utilized to provide better visualization, improve accuracy, and enable less invasive procedures. The use of noninvasive skin-anchored trackers for navigation is a novel technique, with the few reports on this technique demonstrating safety, feasibility, and significant reductions in radiation exposure compared with conventional fluoroscopy. However, a commonly cited deterrent to wider adoption is the learning curve.
methodsRetrospective review of patients undergoing 1-level minimally invasive lumbar surgery was performed. Outcomes were: (1) time for ION set-up and image-acquisition; (2) operative time; (3) fluoroscopy time; (4) radiation dose; (5) operative complications; (6) need for repeat spin; (7) incorrect localization.Chronologic case number was plotted against each outcome. Derivative of the nonlinear curve fit to the dataset for each outcome was solved to find plateau in learning.
resultsA total of 270 patients [114 microdiscectomy; 79 laminectomy; 77 minimally invasive transforaminal lumbar interbody fusion (MI-TLIF)] were included. (1) ION set-up and image-acquisition: no learning curve for microdiscectomy. Proficiency at 23 and 31 cases for laminectomy and MI-TLIF, respectively. (2) Operative time: no learning curve for microdiscectomy. Proficiency at 36 and 31 cases for laminectomy and MI-TLIF, respectively. (3) Fluoroscopy time: no learning curve. (4) Radiation dose: proficiency at 42 and 33 cases for microdiscectomy and laminectomy, respectively. No learning curve for MI-TLIF. (5) Operative complications: unable to evaluate for microdiscectomy and MI-TLIF. Proficiency at 29 cases for laminectomy. (6) Repeat spin: unable to evaluate for microdiscectomy and laminectomy. For MI-TLIF, chronology was not associated with repeat spins. (7) Incorrect localization: none.
conclusionsSkin-anchored ION did not result in any wrong level surgeries. Learning curve for other parameters varied by surgery type, but was achieved at 25-35 cases for a majority of outcomes. LEVEL OF EVIDENCE: Level III.
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