ArticleJournal of orthopaedic surgery and research2023
Learning curve for biportal endoscopic posterior cervical foraminotomy determined using the cumulative summation test.
Article in Journal of orthopaedic surgery and research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Learning curve insights in Unilateral Biportal Endoscopic (UBE) spinal procedures: proficiency cutoffs and the impact on efficiency and complications.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 · 2025Pooled it
- Delta large-channel endoscopy versus unilateral biportal endoscopy for cervicothoracic junction disc herniation: a prospective randomized controlled trial.Journal of orthopaedic surgery and research · 2026Trial
- Observational Cohort Study in Full Endoscopic Lumbar Discectomy: Good Patient Outcomes Despite Learning Curve.International journal of spine surgery · 2026Article
- Full-Endoscopic Posterior Cervical Decompression Versus Anterior Cervical Discectomy and Fusion: A Systematic Review and Meta-Analysis.Global spine journal · 2026Review
- Short term complications and risk factors of unilateral biportal endoscopic cervical spine surgery in patients with cervical radiculopathy and myelopathy: a single center retrospective study.Frontiers in medicine · 2026Article
- Comparison between unilateral biportal endoscopic and percutaneous posterior endoscopic cervical keyhole surgery for patients with cervical spondylotic radiculopathy.Frontiers in surgery · 2026Article
- Article
- [Research progress of unilateral biportal endoscopy technology in cervical degenerative disease].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025Review
- The unilateral biportal endoscopy journey: proposing a 10-tier difficulty progression framework for unilateral biportal endoscopy.Asian spine journal · 2025Article
- Learning curve for full-endoscopic lumbar decompression via interlaminar approach using the learning curve cumulative summation analysis.Journal of orthopaedic surgery and research · 2025Article
- Data Inconsistency, Cost Paradox, and Learning Curve Bias: Critical Concerns Regarding the EUBS Study [Letter].Journal of pain research · 2025Article
- Complications in Minimally Invasive Spine Surgery in the Last 10 Years: A Narrative Review.Neurospine · 2024Article
- Article
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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
backgroundLearning curves describe the rate of performance improvements corresponding to the surgeon's caseload, followed by a plateau where limited further improvements are observed. This study aimed to determine the learning curve for biportal full-endoscopic posterior cervical foraminotomy (BE-PCF) for the unilateral cervical foraminal disc.
methodsThe learning curve was evaluated using a learning curve cumulative summation test (LC-CUSUM). The goal for the operation time was set to 78 min, which is the mean operation time (mOT) of percutaneous full-endoscopic posterior cervical foraminotomy (PE-PCF) performed by a senior surgeon. Moreover, clinical outcomes and post-operative complications were compared between the early and late learning periods 1 year post-operatively.
resultsThis study enrolled the first 50 patients who underwent single-level BE-PCF, performed by a single surgeon. The LC-CUSUM signalled competency for surgery at the 20th operation, indicating that sufficient evidence was obtained to prove that the surgeon was competent. The mOT was 71.29 ± 11.69 min in BE-PCF, 71.84 ± 12.61 min in the early learning period, and 67.83 ± 10.31 min in the late learning period (p = 0.254). There was no statistical difference in clinical outcomes, visual analogue scale scores, and neck disability index between both periods (p > 0.05). Four complications were recorded throughout the whole period, with three in the early period and one in the late period (p = 0.285).
conclusionOur study shows that BE-PCF has a learning curve of 20 caseloads to achieve 90% proficiency, and it significantly reduces the operation time based on the performance of a senior surgeon proficient in PE-PCF.
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Registered trials
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.