LEARNING CURVE IN SINGLE-LEVEL MINIMALLY INVASIVE TLIF: EXPERIENCE OF A NEUROSURGEON

• Main Authors: Samuel Romano-Feinholz, Sergio Soriano-Solís, Julio César Zúñiga-Rivera, Carlos Francisco Gutiérrez-Partida, Manuel Rodríguez-García, Héctor Antonio Soriano-Solís, José Antonio Soriano-Sánchez
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Coluna (SBC)
• Series: Coluna/Columna
• Subjects: Curva de aprendizado; Vértebras Lombares; Fusão vertebral; Procedimentos cirúrgicos minimamente invasivos; Degeneração do disco intervertebral; Resultado do tratamento
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512017000400279&lng=en&tlng=en

ABSTRACT Objective: To describe the learning curve that shows the progress of a single neurosurgeon when performing single-level MI-TLIF. Methods: We included 99 consecutive patients who underwent single-level MI-TLIF by the same neurosurgeon (JASS). Patient’s demographic characteristics were analyzed. In addition, surgical time, intraoperative blood loss and hospital stay were evaluated. The learning curves were calculated with a piecewise regression model. Results: The mean age was 54.6 years. The learning curves showed an inverse relationship between the surgical experience and the variable analyzed, reaching an inflection point for surgical time in case 43 and for blood loss in case 48. The mean surgical time was 203.3 minutes (interquartile range [IQR] 150-240 minutes), intraoperative bleeding was 97.4ml (IQR 40-100ml) and hospital stay of four days (IQR 3-5 days). Conclusions: MI-TLIF is a very frequent surgical procedure due to its effectiveness and safety, which has shown similar results to open procedure. According to this study, the required learning curve is slightly higher than for open procedures, and is reached after about 45 cases.