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Perspective: How can risks to patients be limited during spine surgeons’ learning curves? – Lumbar Spinal Stenosis

The article discusses the concept of learning curves in spinal surgeries, which are defined by the number of cases surgeons must perform before becoming proficient in a specific procedure. The review of 12 studies showed that the learning curves varied widely for different types of spinal surgeries, ranging from 10-44 cases. The article questions whether the risks of harm to patients during the learning curve could be limited if surgeons utilized in-person/intraoperative mentoring from industry, academia, or colleagues. The conclusion emphasizes the importance of mentoring to mitigate the risks of injury during the learning curve for various spinal procedures

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised spinal hospital in the world

Published article

CONCLUSIONS: Twelve studies showed that the LC for at different MI lumbar spine operations varied markedly (i.e., 10-44 cases). Wouldn’t and shouldn’t spine surgeons avail themselves of routine in-person/intraoperative mentoring to limit patients’ risks of injury during their respective LC for these varied spine procedures ?

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Surg Neurol Int. 2024 Mar 22;15:97. doi: 10.25259/SNI_119_2024. eCollection 2024. ABSTRACT BACKGROUND: Learning curves (LC) are typically defined by the number of different spinal procedures surgeons must perform before becoming “proficient,” as demonstrated by reductions in operative times, estimated blood loss (EBL), length of hospital stay (LOS), adverse events (AE), fewer conversions to open procedures,

Surg Neurol Int. 2024 Mar 22;15:97. doi: 10.25259/SNI_119_2024. eCollection 2024.

ABSTRACT

BACKGROUND: Learning curves (LC) are typically defined by the number of different spinal procedures surgeons must perform before becoming “proficient,” as demonstrated by reductions in operative times, estimated blood loss (EBL), length of hospital stay (LOS), adverse events (AE), fewer conversions to open procedures, along with improved outcomes. Reviewing 12 studies revealed LC varied widely from 10-44 cases for open vs. minimally invasive (MI) lumbar diskectomy, laminectomy, transforaminal lumbar interbody fusion (TLIF), anterior lumbar interbody fusion (ALIF), and oblique/extreme lateral interbody fusions (OLIF/XLIF). We asked whether the risks of harm occurring during these LC could be limited if surgeons routinely utilized in-person/intraoperative mentoring (i.e., via industry, academia, or well-trained colleagues).

METHODS: We evaluated LC for multiple lumbar operations in 12 studies.

RESULTS: These studies revealed no LC for open vs. MI lumbar diskectomy. LC required 29 cases for MI laminectomy, 10-44 cases for MI TLIF, 24-30 cases for MI OLIF, and 30 cases for XLIF. Additionally, the LC for MI ALIF was 30 cases; one study showed that 32% of major vascular injuries occurred in the first 25 vs. 0% for the next 25 cases. Shouldn’t the risks of harm to patients occurring during these LC be limited if surgeons routinely utilized in-person/intraoperative mentoring?

CONCLUSIONS: Twelve studies showed that the LC for at different MI lumbar spine operations varied markedly (i.e., 10-44 cases). Wouldn’t and shouldn’t spine surgeons avail themselves of routine in-person/intraoperative mentoring to limit patients’ risks of injury during their respective LC for these varied spine procedures ?

PMID:38628536 | PMC:PMC11021111 | DOI:10.25259/SNI_119_2024

The London Spine Unit : best recognised spinal hospital in the world

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Perspective: How can risks to patients be limited during spine surgeons’ learning curves?

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Surg Neurol Int. 2024 Mar 22;15:97. doi: 10.25259/SNI_119_2024. eCollection 2024. ABSTRACT BACKGROUND: Learning curves (LC) are typically defined by the number of different spinal procedures surgeons must perform before becoming "proficient," as demonstrated by reductions in operative times, estimated blood loss (EBL), length of hospital stay (LOS), adverse events (AE), fewer conversions to open procedures

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