Wang Ning, Bei Chaoyong, Wan Jian, Wang Honggang
Department of Spine Surgery, Affiliated Hospital of Guilin Medical College, Guilin Guangxi, 541000, P. R. China.
Department of Trauma Surgery, Affiliated Hospital of Guilin Medical College, Guilin Guangxi, 541000, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022 Oct 15;36(10):1229-1233. doi: 10.7507/1002-1892.202205139.
To analyze the learning curve of unilateral biportal endoscopic lumbar interbody fusion (UBE-LIF).
Fifty-five patients with single-segment lumbar degenerative disease treated with UBE-LIF between December 2020 and February 2022 were selected as the research subjects. The patients were grouped according to the operation sequence, the first 27 cases were in the early group, and the last 28 cases were in the late group. There was no significant difference between the two groups in age, gender, disease type, and surgical segment distribution ( >0.05). The operation time, the amount of hemoglobin loss (the difference between 1 day before operation and 3 days after operation), the hospital stay after operation, and the incidence of perioperative complications were recorded; the learning curve of UBE-LIF was analyzed by log-curve regression analysis.
All the operations were successfully completed without changing to other operations. The operation time, the amount of hemoglobin loss, and hospital stay in the early group were significantly more than those in the late group ( <0.05). Complications occurred in 2 cases (7.4%) in the early group, including 1 case of dural tear during operation and 1 case of epidural hematoma after operation, and 1 case (3.6%) with transient radiculitis in the late group. There was no significant difference in the incidence of complications between the two groups ( =0.518) . The log-curve regression analysis showed that the operation time decreased significantly with the increase of the number of patients ( <0.05). The operation time tended to be stable after the surgeon completed 17 cases.
For single-level lumbar degenerative disease, the operation time of UBE-LIF can decrease gradually with the increase of the number of patients, and tend to be stable after 17 cases.
分析单侧双通道内镜下腰椎椎间融合术(UBE-LIF)的学习曲线。
选取2020年12月至2022年2月期间接受UBE-LIF治疗的55例单节段腰椎退行性疾病患者作为研究对象。根据手术顺序将患者分组,前27例为早期组,后28例为晚期组。两组在年龄、性别、疾病类型和手术节段分布方面无显著差异(P>0.05)。记录手术时间、血红蛋白丢失量(术前1天与术后3天的差值)、术后住院时间及围手术期并发症发生率;采用对数曲线回归分析UBE-LIF的学习曲线。
所有手术均顺利完成,未转为其他术式。早期组的手术时间、血红蛋白丢失量和住院时间均显著多于晚期组(P<0.05)。早期组发生并发症2例(7.4%),包括术中硬膜撕裂1例和术后硬膜外血肿1例,晚期组发生1例(3.6%)短暂性神经根炎。两组并发症发生率无显著差异(P=0.518)。对数曲线回归分析显示,手术时间随患者例数增加而显著缩短(P<0.05)。术者完成17例手术后手术时间趋于稳定。
对于单节段腰椎退行性疾病,UBE-LIF的手术时间可随患者例数增加而逐渐缩短,17例后趋于稳定。