ArticleActa neurochirurgica2026
Operative time, recurrence, and complications throughout the initial learning curve in transforaminal endoscopic lumbar discectomy.
Article in Acta neurochirurgica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTransforaminal Endoscopic Lumbar Discectomy (TELD) is increasing in popularity as a minimally invasive technique for treating lumbar disc herniation (LDH). However, TELD presents technical challenges that may result in a flat learning curve. This study analysed the first patients treated by a single senior neurosurgeon transitioning from tubular microdiscectomy, focussing on the initial learning curve for operative time, recurrence, and complications.
methodsA retrospective study was conducted using data from a consecutive cohort of the first 213 patients operated for LDH by TELD. We collected basic demographic data and recorded all complications, recurrences, and operative time, among other clinical outcome measures. For analytical purposes (trend testing), the learning curve was divided into four quarters of each approx. 50 patients.
resultsThe cohort included 101 (47.4%) females and 112 (52.6%) males, with a mean age of 44.2 ± 11.8 years. An initial steep decrease in operative time after 50 cases performed was observed, decreasing by 21.9 ± 27.7 min (p < 0.001), with operative time showing no further change after those initial 50 cases. Residual LDH was seen in 2 (0.9%) patients. Seventeen (8.0%) patients experienced recurrence of LDH. No statistically significant trend in recurrence rate between quarters was observed (p = 0.99). Complications were experienced by 11 (5.2%) patients, without a significant trend (p = 0.50).
conclusionsThis study demonstrates a clear and steep learning curve for TELD, as shown by a significant decrease in operative time that stabilized after approximately 50 cases. This rapid improvement shows growing familiarity with the technically demanding procedure. In our experience, the initial step of the docking process remains the most challenging aspect, largely due to patient-specific variations. Understanding the initial learning curve is essential for training and surgical planning when transitioning to endoscopic techniques.
Indexed as
Identifiers
What OpenQuestion holds
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.