ReviewSurgical neurology international2024
Perspective: How can risks to patients be limited during spine surgeons' learning curves?
Review in Surgical neurology international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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1 author at 1 institution in 1 country.
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Abstract
Background: Learning curves (LC) are typically defined by the number of different spinal procedures surgeons must perform before becoming "proficient," as demonstrated by reductions in operative times, estimated blood loss (EBL), length of hospital stay (LOS), adverse events (AE), fewer conversions to open procedures, along with improved outcomes. Reviewing 12 studies revealed LC varied widely from 10-44 cases for open vs. minimally invasive (MI) lumbar diskectomy, laminectomy, transforaminal lumbar interbody fusion (TLIF), anterior lumbar interbody fusion (ALIF), and oblique/extreme lateral interbody fusions (OLIF/XLIF). We asked whether the risks of harm occurring during these LC could be limited if surgeons routinely utilized in-person/intraoperative mentoring (i.e., via industry, academia, or well-trained colleagues). Methods: We evaluated LC for multiple lumbar operations in 12 studies. Results: These studies revealed no LC for open vs. MI lumbar diskectomy. LC required 29 cases for MI laminectomy, 10-44 cases for MI TLIF, 24-30 cases for MI OLIF, and 30 cases for XLIF. Additionally, the LC for MI ALIF was 30 cases; one study showed that 32% of major vascular injuries occurred in the first 25 vs. 0% for the next 25 cases. Shouldn't the risks of harm to patients occurring during these LC be limited if surgeons routinely utilized in-person/intraoperative mentoring? Conclusions: Twelve studies showed that the LC for at different MI lumbar spine operations varied markedly (i.e., 10-44 cases). Wouldn't and shouldn't spine surgeons avail themselves of routine in-person/intraoperative mentoring to limit patients' risks of injury during their respective LC for these varied spine procedures ?
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