Evidence map›Paper›PMID 41603993›Full record

Observational studyEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026

Impact of arthroscopic experience on the learning curve in interlaminar endoscopic lumbar discectomy: a single-center prospective cohort study of 240 patients.

Tomasz Sienkiel, Marcin Gąska, Przemysław Koszyk, Ewa Lipik, Barbara Jasiewicz

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study 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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

5 authors.

Tomasz SienkielDepartment of Orthopedic Surgery, University Orthopedic and Rehabilitation Hospital, Zakopane, Poland. sienkiel.tomasz@gmail.com.
Marcin GąskaDepartment of Orthopedic Surgery, University Orthopedic and Rehabilitation Hospital, Zakopane, Poland.
Przemysław KoszykDepartment of Orthopedic Surgery, University Orthopedic and Rehabilitation Hospital, Zakopane, Poland.
Ewa LipikDepartment of Orthopedic Surgery, University Orthopedic and Rehabilitation Hospital, Zakopane, Poland.
Barbara JasiewiczDepartment of Orthopedic Surgery, University Orthopedic and Rehabilitation Hospital, Zakopane, Poland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designProspective single-center observational cohort study.

objectivesTo assess whether prior arthroscopic experience is associated with a shorter learning curve in uniportal interlaminar endoscopic lumbar discectomy (IELD), primarily in terms of operative efficiency, and to descriptively evaluate perioperative complications and patient-reported outcomes.

methodsIn accordance with STROBE guidelines, 240 consecutive patients with single-level lumbar disc herniation (MSU A/B, non-calcified, symptom duration ≤ 3 months) underwent IELD between 2021 and 2023 at a single academic orthopedic center. Procedures were performed by three spine surgeons without prior endoscopic experience; one surgeon had performed more than 300 shoulder arthroscopies. Operative time was analyzed using cumulative sum (CUSUM) methodology and linear regression. Missing outcome data were handled using last observation carried forward. Complications were recorded descriptively and stratified by learning phase and surgeon. Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores for back and leg pain were assessed preoperatively and at 3 and 12 months.

resultsAll surgeons demonstrated a three-phase learning curve consisting of learning, improvement, and stabilization phases. Operative efficiency stabilized after approximately 50 cases across surgeons. The surgeon with prior arthroscopic experience reached the CUSUM inflection point earlier (case 12) compared with the other surgeons (cases 24-26). The overall major complication rate was 9.2% and was highest during the initial learning phase. ODI and VAS scores improved significantly at 3 and 12 months (all p < 0.001), with no statistically significant between-surgeon differences at final follow-up.

conclusionsPrior arthroscopic experience was associated with earlier adaptation during the initial learning phase of IELD, as measured by operative time. Following procedural stabilization, no statistically significant differences were detected in operative efficiency, major complication rates, or patient-reported outcomes between surgeons. These findings suggest that arthroscopic experience may facilitate early adaptation to endoscopic visualization and workflow but does not independently determine long-term clinical outcomes. LEVEL OF EVIDENCE: III.

Indexed as

ArthroscopyClinical CompetenceDiskectomyEndoscopyIntervertebral Disc DisplacementLearning CurveLumbar VertebraeAdultAgedFemaleHumansMaleMiddle AgedProspective StudiesTreatment OutcomeArthroscopic experienceCUSUM analysisEndoscopic lumbar discectomyInterlaminar approachLearning curveMinimally invasive spine surgerySurgical education

Identifiers

PMID41603993

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.