Division of Neurosurgery, Buddhist Tzu Chi Hospital, Taipei Branch, Taipei, Taiwan.
Eur Spine J. 2013 Apr;22(4):727-33. doi: 10.1007/s00586-012-2540-4. Epub 2012 Oct 17.
PURPOSE: To report the learning curve of full-endoscopic lumbar discectomy for a surgeon naive to endoscopic surgery but trained in open microdiscectomy. METHODS: From July 2006 to July 2009, 57 patients underwent full-endoscopic lumbar discectomy and 66 underwent open microdiscectomy. The clinical results were evaluated with a visual analog scale (VAS) and the Oswestry Disability Index (ODI). Spearman's coefficient of rank correlation (rho) was used to assess the learning curves for the transforaminal and interlaminar procedures of full-endoscopic lumbar discectomy. RESULTS: After full-endoscopic lumbar discectomy, the VAS and ODI results of the patients followed up were comparable with those of open microdiscectomy. A steep learning curve was observed for the transforaminal procedure, but not the interlaminar procedure. CONCLUSIONS: The learning curve of the transforaminal approach was steep and easy to learn, while the learning curve of the interlaminar approach was flat and hard to master.
目的：报告一位对内镜手术不熟悉但接受过开放显微切除术培训的外科医生全内窥镜腰椎间盘切除术的学习曲线。
方法：从 2006 年 7 月至 2009 年 7 月，57 例患者接受了全内窥镜腰椎间盘切除术，66 例患者接受了开放显微切除术。采用视觉模拟评分（VAS）和 Oswestry 残疾指数（ODI）评估临床结果。Spearman 秩相关系数（rho）用于评估经椎间孔和经椎间孔全内窥镜腰椎间盘切除术的学习曲线。
结果：全内窥镜腰椎间盘切除术后，随访患者的 VAS 和 ODI 结果与开放显微切除术相当。经椎间孔入路的学习曲线陡峭，但经椎间孔入路的学习曲线平坦且难以掌握。
结论：经椎间孔入路的学习曲线陡峭且易于学习，而经椎间孔入路的学习曲线平坦且难以掌握。
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