Wu Kun, Yun Zhihe, Suvithayasiri Siravich, Liang Yihao, Setiawan Dimas Rahman, Kotheeranurak Vit, Jitpakdee Khanathip, Giordan Enrico, Liu Qinyi, Kim Jin-Sung
Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China.
Department of Orthopedics, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand.
Neurospine. 2024 Dec;21(4):1251-1275. doi: 10.14245/ns.2448838.419. Epub 2024 Dec 31.
Our research examines the learning curves of various minimally invasive lumbar surgeries to determine the benefits and challenges they pose to both surgeons and patients. The advent of microsurgical techniques since the 1960s, including advances in fluoroscopic navigation and intraoperative computed tomography, has significantly shifted spinal surgery from open to minimally invasive methods. This study critically evaluates surgical duration, intraoperative conversions to open surgery, and complications as primary parameters to gauge these learning curves. Through a comprehensive literature search up to March 2024, involving databases PubMed, Cochrane Library, and Web of Science, this paper identifies a steep learning curve associated with these surgeries. Despite their proven advantages in reducing recovery time and surgical trauma, these procedures require surgeons to master advanced technology and equipment, which can directly impact patient outcomes. The study underscores the need for well-defined learning curves to facilitate efficient training and enhance surgical proficiency, especially for novice surgeons. Moreover, it addresses the implications of technology on surgical accuracy and the subsequent effects on complication rates, providing insights into the complex dynamics of adopting new surgical innovations in spinal health care.
我们的研究考察了各种微创腰椎手术的学习曲线,以确定它们给外科医生和患者带来的益处与挑战。自20世纪60年代以来,显微外科技术的出现,包括荧光镜导航和术中计算机断层扫描技术的进步,已使脊柱手术从开放手术显著转向微创手术。本研究严格评估手术时长、术中转为开放手术的情况以及并发症,将其作为衡量这些学习曲线的主要参数。通过截至2024年3月的全面文献检索,涉及PubMed、Cochrane图书馆和科学网数据库,本文确定了与这些手术相关的陡峭学习曲线。尽管这些手术在缩短恢复时间和减少手术创伤方面已被证实具有优势,但这些手术要求外科医生掌握先进技术和设备,而这会直接影响患者的治疗效果。该研究强调需要明确的学习曲线,以促进高效培训并提高手术熟练程度,尤其是对新手外科医生而言。此外,它还探讨了技术对手术准确性的影响以及对并发症发生率的后续影响,为在脊柱医疗保健中采用新的手术创新的复杂动态情况提供了见解。