Biportal Endoscopic Spine Surgery for Lumbar Laminectomy and Diskectomy: Postoperative Outcomes and Surgical Learning Curve, a Single US Surgeon's Experience.

Matthew Easthardt, Philip Zakko, Ali Jawad, Maximillian Lee, Daniel Park
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Abstract

Introduction: Biportal endoscopic spine surgery (BESS) has gained traction for lumbar laminectomy and diskectomy. To justify the transition to BESS, outcomes and the surgical learning curve should be known. This study evaluates rates of complications with BESS and how these rates change with increased surgeon experience.

Methods: A single surgeon's consecutive patients who underwent BESS were evaluated. Patients older than 18 years who underwent BESS for lumbar laminectomy and diskectomy were included. Patients with previous spine surgery, multiple levels, or BESS for fusion were excluded. Demographics, length of surgery, intraoperative complications, postoperative complications, and revision surgery were recorded. The learning phase group and mastery phase group were based on a cumulative summation analysis based on surgical time.

Results: A total of 63 patients, with 31 and 32 patients in the learning and mastery group, respectively, were included. Surgical time decreased from 87 to 52 minutes in the mastery phase. Conversion to open decreased from 3 to 0 cases (P = 0.1803), intraoperative complications decreased from 3 to 0 (P = 0.1803), postoperative complications decreased from 7 to 2 (P = 0.017), and rates of revision surgery decreased from 4 to 1 (P = 0.4233).

Conclusion: This study suggests a learning curve of 31 cases for adequate performance of BESS for lumbar laminectomy and diskectomy.

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腰椎间盘切除术的双门内窥镜脊柱手术:术后效果和手术学习曲线,一位美国外科医生的经验。
导言:双门内窥镜脊柱手术(BESS)已在腰椎椎板切除术和椎间盘切除术中得到广泛应用。为了证明向 BESS 过渡的合理性,应了解其结果和手术学习曲线。本研究评估了 BESS 的并发症发生率,以及这些发生率是如何随着外科医生经验的增加而变化的:方法:对一名外科医生的连续 BESS 患者进行评估。方法:对一名外科医生的连续 BESS 患者进行了评估。患者年龄在 18 岁以上,接受过腰椎板切除术和椎间盘切除术。曾接受过脊柱手术、多层次手术或因融合术而接受 BESS 的患者除外。研究人员记录了患者的人口统计学特征、手术时间、术中并发症、术后并发症和翻修手术。学习阶段组和掌握阶段组是基于手术时间的累积总和分析:共纳入 63 名患者,其中学习组和掌握组分别有 31 名和 32 名患者。在掌握阶段,手术时间从87分钟减少到52分钟。转为开腹手术的病例从3例减少到0例(P=0.1803),术中并发症从3例减少到0例(P=0.1803),术后并发症从7例减少到2例(P=0.017),翻修手术率从4例减少到1例(P=0.4233):本研究表明,在腰椎椎板切除术和腰椎间盘切除术中充分实施 BESS 需要 31 个病例的学习曲线。
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来源期刊
CiteScore
2.60
自引率
6.70%
发文量
282
审稿时长
8 weeks
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