Learning curve for endoscopic posterior cervical foraminotomy

Perfetti, Dean C.; Rogers-LaVanne, Mary P; Satin, Alexander M.; Yap, Natalie; Khan, Imad Saeed; Kim, Patrick; Hofstetter, Christoph P.; Derman, Peter B.

doi:10.1007/s00586-023-07623-6

Cited by 6 publications

(15 citation statements)

References 20 publications

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“…A total of three articles were included from a total of 792 articles initially retrieved from the three databases. [5][6][7] Refer to Figure 1 for the PRISMA diagram for this study. The mean MINORS score for the three included articles was 16.3 2.9 points.…”

Section: Search Results and Article Qualitymentioning

confidence: 99%

“…The mean MINORS score for the three included articles was 16.3 2.9 points. [5][6][7] Refer to Table 1 for more information on quality grading.…”

Section: Search Results and Article Qualitymentioning

confidence: 99%

“…The FWM preoperative arm pain VAS was 5.4 0.4 points (n = 94 patients) and the FWM postoperative arm pain VAS was 2.6 0.5 points (n = 87) for surgeries performed in the competency phase. Unfortunately, there was wide variety in postoperative timepoints for the NDI and VAS outcomes between the two reporting studies, with Perfetti et al 5 not reporting a postoperative timepoint and Yao et al 7 reporting an average follow-up time of 17.6 2.8 months. Information from the included articles concerning pain and disability outcomes is summarized in Table 3.…”

Section: Pain and Disabilitymentioning

confidence: 99%

“…2,3 Despite this fact, endoscopic cervical spine procedures, such as endoscopic cervical foraminotomy, are innovative minimally invasive surgical techniques emerging in the literature for surgical management of cervical pathology without the use of open incision. [4][5][6][7][8][9][10] Although numerous benefits have been ascribed to endoscopic surgical management of cervical conditions, endoscopic cervical spine surgery is believed to have a steep learning curve, which may impact patient outcomes and discourage surgeon utilization. [4][5][6][7] The impact of the learning curve has been established in the literature for other minimally invasive techniques and has been examined in multiple studies regarding lumbar endoscopic surgery.…”

mentioning

confidence: 99%

“…[4][5][6][7][8][9][10] Although numerous benefits have been ascribed to endoscopic surgical management of cervical conditions, endoscopic cervical spine surgery is believed to have a steep learning curve, which may impact patient outcomes and discourage surgeon utilization. [4][5][6][7] The impact of the learning curve has been established in the literature for other minimally invasive techniques and has been examined in multiple studies regarding lumbar endoscopic surgery. [11][12][13][14][15] However, no systematic review and meta-analysis exists that examines the impact of the learning curve on patient outcomes and complications with endoscopic cervical foraminotomy to date in the literature, although several individual observational studies have been published recently, indicating interest in this specific topic.…”

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confidence: 99%

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Outcomes and Complications Associated With the Learning Curve for Endoscopic Cervical Foraminotomy

Baumann,

Callaghan,

Walley

et al. 2023

Spine

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Study Design. Systematic review and meta-analysis. Objective. The objective of this study is to examine the impact of the learning curve for endoscopic cervical foraminotomy for clinical outcomes and patient safety. Summary of Background Data. Endoscopic cervical foraminotomy is a minimally invasive surgical technique emerging in the literature for surgical management of cervical radiculopathy without the use of open incision. The adoption of endoscopic cervical foraminotomy may be hindered by the learning curve, although no review and meta-analysis exists to date on the topic. Methods. A systematic review and meta-analysis was performed using PubMed, CINAHL, and MEDLINE from database inception until July 11th, 2023. Inclusion criteria were articles that examined endoscopic cervical foraminotomy, reported outcomes and/or complications for endoscopic cervical spine surgery relevant to the learning curve and had full-text. A random effects meta-analysis was performed for outcomes and complications. Results. A total of three articles (n=203 patients) were included from 792 articles initially retrieved. The learning curves from four surgeons were examined with a frequency weighted mean 21 procedures until the competency phase. There was no significant difference in the postoperative hospitalization length (P=0.669), postoperative recovery room time (P=0.415), intraoperative blood loss (P=0.064), and total complication rates (10.9% vs. 1.2%, P=0.139) between endoscopic cervical foraminotomy procedures performed in the learning phase as compared to the competency phase of the learning curve. There was a significant decrease in operative time from the learning phase to the competency phase (P=0.005). Conclusion. Competency was achieved on the learning curve for endoscopic cervical foraminotomy after about 21 procedures. There is no significant difference in postoperative hospitalization time, postoperative recovery room time, intraoperative blood loss, and complication rates between the learning phase and the competency phase of the learning curve for endoscopic cervical foraminotomy, noting the relatively small sample size of this study that may underpower this finding.

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Section: Search Results and Article Qualitymentioning

confidence: 99%

“…The mean MINORS score for the three included articles was 16.3 2.9 points. [5][6][7] Refer to Table 1 for more information on quality grading.…”

Section: Search Results and Article Qualitymentioning

confidence: 99%