Evidence map›Paper›PMID 34974418›Full record

ArticleInternational journal of spine surgery2021

Difficulties, Challenges, and the Learning Curve of Avoiding Complications in Lumbar Endoscopic Spine Surgery.

Kai-Uwe Lewandrowski, Albert E Telfeian, Stefan Hellinger, Jorge Felipe Ramírez León, Paulo Sérgio Teixeira de Carvalho, Max R F Ramos, Hyeun Sung Kim, Daniel W Hanson, Nimar Salari, Anthony Yeung

Open access · diamondAbstract read
In one paragraph

Article in International journal of spine surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 1 pooled it
5.6field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.

  1. Percutaneous transforaminal endoscopic discectomy in patients with lumbar disc herniation: a meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
    Pooled it
  2. Validation of a modular low-fidelity training model for biportal endoscopic spine surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
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  16. Evolving Role of Lumbar Decompression: A Narrative Review.International journal of spine surgery · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 6 countries.

Kai-Uwe LewandrowskiStaff Orthopaedic Spine Surgeon Center for Advanced Spine Care of Southern Arizona and Surgical Institute of Tucson, Tuscon, Arizona business@tucsonspine.com.
Albert E TelfeianDepartment of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Stefan HellingerDepartment of Orthopedic Surgery, Arabellaklinik, Munich, Germany.
Jorge Felipe Ramírez LeónCentro de Columna - Cirugía Mínima Invasiva, Clínica Reina Sofía - Clínica Colsanitas, Bogotá, D.C., Colombia.
Paulo Sérgio Teixeira de CarvalhoFederal University of the State of Rio de Janeiro UNIRIO, Rio de Janeiro, Brazil.
Max R F RamosFederal University of the State of Rio de Janeiro UNIRIO, Rio de Janeiro, Brazil.
Hyeun Sung KimDepartment of Neurosurgery, Nanoori Hospital, Seoul City, Republic of Korea.
Daniel W HansonMinnesota Spine Institute, Roseville, Minnesota.
Nimar SalariDesert Institute for Spine Care, Phoenix, Arizona.
Anthony YeungDesert Institute for Spine Care, Phoenix, Arizona.
Desert Institute For Spine Care · USHospital Universitário Gaffrée e Guinle · BRBrown University · USChikamori Hospital · JPClinica Santa Maria · CLThe Spine Institute · USUniversidade Federal do Estado do Rio de Janeiro · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Spinal endoscopy has the stigma of being reserved for only a few surgeons who can figure out how to master the steep learning curve and develop clinical practice settings where endoscopic spine surgery can thrive. In essence, endoscopic treatment of herniated discs specifically and nerve root compression in the lumbar spine in general amounts to replacing traditional open spine surgery protocols with spinal endoscopic surgery techniques. In doing so, the endoscopic spine surgeon must be confident that the degenerative spine's common painful problems can be handled with endoscopic spinal surgery techniques with at least comparable clinical results and complication rates. In this review article, the authors illustrate the difficulties and challenges of the endoscopic lumbar decompression procedure. In addition, they shed light on how to master the learning curve by systematically looking at all sides of the problem, ranging from the ergonomic aspects of the endoscopic platform and its instruments, surgical access planning, challenging clinical scenarios, complications, and sequelae, as well as the training gaps after postgraduate residency and fellowship programs.

Indexed as

complicationsdifficultieslearning curvelumbar endoscopic surgerysequalae

Identifiers

PMID34974418
PMCPMC9421222
OpenAlexW4206335334

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.