LEARNING CURVE OF FULL ENDOSCOPIC LUMBAR SPINE SURGERY; A RETROSPECTIVE ANALYSIS AT FAROOQ NEUROSPINE INSTITUTE, PESHAWAR
DOI:
https://doi.org/10.52442/rjhs.v6i2.424Keywords:
endoscopic surgery, learning curve, lumbar spineAbstract
Introduction: Learning curve for minimally invasive endoscopic spine surgeries is the required time in which a surgeon becomes proficient in the skill of operating through the endoscope along with the quantity and number of cases needed to master specific Minimally Invasive endoscopic spinal procedures .The aim of this retrospective study was to investigate the learning curve of full endoscopic lumber spine surgery from the experience of an individual practicing endoscopic spine neurosurgeon.
Material & Methods: The records of patients who underwent full endoscopic spine surgery from March 2018 to March 2022 were evaluated at Afridi Medical Complex, Peshawar. To evaluate the learning curve, cases were categorized into four sequential groups based on the order of surgeries performed. Group 1 comprised the initial cases encompassing first year (2018-2019), and subsequent cases were grouped into Group 2, 3 and 4 representing year 2019-2020,2020-2021,2021-2022. The learning curve was assessed through the analysis of various outcome parameters, including operative time, intraoperative complications, postoperative complications, length of hospital stay, and patient-reported outcomes.
Results: A total of 543 patients met the inclusion criteria and were included in the analysis. The majority of patients were males (n =346, 64%) and 194(36) % were female. Mean operative time reached to plateau level at 160th surgery. Mean operative time decreased throughout each year from 90 minutes (Group 1) to 75 (Group 2), 60 (Group 3) and 45 (Group 4).
Conclusion: Progressive reduction in operative time and favorable patient-reported outcomes along with decreased complications are noted as surgical experience increased in operating endoscopic spine surgeries. These results underscore the importance of ongoing training and proficiency in full endoscopic techniques, ultimately enhancing patient care and outcomes in neurosurgical practice.
