ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2023
Initial learning curve after switching to uniportal endoscopic discectomy for lumbar disc herniations.
Article in 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, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 14 citations in OpenAlex.
- A Simplified and Efficient Transforaminal Endoscopic Lumbar Discectomy Technique With Reduced Radiation: A Retrospective Study.International journal of spine surgery · 2026Article
- A Systematic Review of Complication Management During Uniportal and Biportal Endoscopic Spine Surgery: Dural Tear and Bleeding.Global spine journal · 2026Article
- The learning curve of percutaneous endoscopic interlaminar discectomy versus unilateral biportal endoscopic discectomy for lumbar disc herniation: a comparative study.Journal of orthopaedic surgery and research · 2026Article
- Lateral full-endoscopic lumbosacral foraminotomy for foraminal stenosis in dogs: technique development and initial case series.Frontiers in veterinary science · 2026Article
- Learning curve in full-endoscopic lumbar surgery for disc herniation in a spine clinic in Mexico: Comparative analysis of IELD and TELD techniques.Brain & spine · 2026Article
- Article
- Learning Curve of Uniportal Compared With Biportal Endoscopic Techniques for the Treatment of Lumbar Disc Herniation.Orthopaedic surgery · 2025Article
- Evolving Paradigms in Spinal Surgery: A Systematic Review of the Learning Curves in Minimally Invasive Spine Techniques.Neurospine · 2024Article
- Lumbar percutaneous transforaminal endoscopic discectomy: a retrospective survey on the first 172 adult patients treated in Denmark.Acta neurochirurgica · 2024Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose was to investigate the learning curve for elective endoscopic discectomy performed by a single surgeon who made a complete switch to uniportal endoscopic surgery for lumbar disc herniations in an ambulatory surgery center and determine the minimum case number required to safely overcome the initial learning curve.
methodsElectronic medical records (EMR) of the first 90 patients receiving endoscopic discectomy by the senior author in an ambulatory surgery center were reviewed. Cases were divided by approach, transforaminal (46) versus interlaminar (44). Patient-reported outcome measures (visual-analog-score (VAS) and the Oswestry disability index (ODI)) were recorded preoperatively and at 2-week, 6-week, 3-month, and 6-month appointments. Operative times, complications, time to discharge from PACU, postoperative narcotic use, return to work, and reoperations were compiled.
resultsMedian operative time decreased approximately 50% for the first 50 patients then plateaued for both approaches (mean: 65 min). No difference in reoperation rate observed during the learning curve. Mean time to reoperation was 10 weeks, with 7(7.8%) reoperations. The interlaminar and transforaminal median operative times were 52 versus 73 min, respectively (p = 0.03). Median time to discharge from PACU was 80 min for interlaminar approaches and 60 min for transforaminal (p < 0.001). Mean VAS and ODI scores 6 weeks and 6 months postoperatively were statistically and clinically improved from preoperatively. The duration of postoperative narcotic use and narcotics need significantly decreased during the learning curve as the senior author realized that narcotics were not needed. No differences were apparent between groups in other metrics.
conclusionsEndoscopic discectomy was shown to be safe and effective for symptomatic disc herniations in an ambulatory setting. Median operative time decreases by half over the first 50 patients in our learning curve, while reoperation rates remained similar without the need for hospital transfer or conversion to an open procedure in an ambulatory setting. LEVEL OF EVIDENCE: Level III, prospective cohort.
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