PDF(Pubmed)
Abstract：
UNASSIGNED: 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).
UNASSIGNED: We evaluated LC for multiple lumbar operations in 12 studies.
UNASSIGNED: 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?
UNASSIGNED: 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 ?
UNASSIGNED: We evaluated LC for multiple lumbar operations in 12 studies.
UNASSIGNED: 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?
UNASSIGNED: 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 ?
摘要：
■学习曲线（LC）通常由外科医生在熟练之前必须执行的不同脊柱手术的数量来定义，“正如手术时间的减少所证明的那样，估计失血量（EBL），住院时间（LOS），不良事件（AE），较少转换为开放程序，以及改善的结果。回顾12项研究显示，LC在10-44例开放病例与微创（MI）腰椎间盘切除术，椎板切除术,经椎间孔腰椎椎间融合术(TLIF),前路腰椎椎间融合术(ALIF),和斜/极端侧椎体间融合（OLIF/XLIF）。我们询问如果外科医生常规使用当面/术中指导（即，通过工业，学术界,或训练有素的同事)。
■我们在12项研究中评估了LC的多次腰椎手术。
■这些研究显示开放与开放没有LCMI腰椎间盘切除术。LC需行MI椎板切除术29例,10-44例MITLIF，24-30例MIOLIF，和XLIF的30例。此外,MIALIF的LC为30例；一项研究表明，32％的主要血管损伤发生在前25例vs.0%为接下来的25例。如果外科医生常规使用亲自/术中指导，那么在这些LC期间对患者造成伤害的风险是否应该受到限制？
■12项研究表明，不同MI腰椎手术的LC差异显着（即，10-44例)。脊柱外科医生不应该也不应该利用常规的现场/术中指导来限制患者在这些不同脊柱手术的LC期间受伤的风险？
■我们在12项研究中评估了LC的多次腰椎手术。
■这些研究显示开放与开放没有LCMI腰椎间盘切除术。LC需行MI椎板切除术29例,10-44例MITLIF，24-30例MIOLIF，和XLIF的30例。此外,MIALIF的LC为30例；一项研究表明，32％的主要血管损伤发生在前25例vs.0%为接下来的25例。如果外科医生常规使用亲自/术中指导，那么在这些LC期间对患者造成伤害的风险是否应该受到限制？
■12项研究表明，不同MI腰椎手术的LC差异显着（即，10-44例)。脊柱外科医生不应该也不应该利用常规的现场/术中指导来限制患者在这些不同脊柱手术的LC期间受伤的风险？
