Outcomes and Complications Associated with the Learning Curve for Endoscopic Cervical Foraminotomy: A Systematic Review and Meta-Analysis.
Journal
Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646
Informations de publication
Date de publication:
31 Oct 2023
31 Oct 2023
Historique:
received:
21
08
2023
accepted:
23
10
2023
medline:
31
10
2023
pubmed:
31
10
2023
entrez:
31
10
2023
Statut:
aheadofprint
Résumé
Systematic review and meta-analysis. The objective of this study is to examine the impact of the learning curve for endoscopic cervical foraminotomy for clinical outcomes and patient safety. Endoscopic cervical foraminotomy is a minimally invasive surgical technique emerging in the literature for surgical management of cervical radiculopathy without the use of open incision. The adoption of endoscopic cervical foraminotomy may be hindered by the learning curve, although no review and meta-analysis exists to date on the topic. A systematic review and meta-analysis was performed using PubMed, CINAHL, and MEDLINE from database inception until July 11th, 2023. Inclusion criteria were articles that examined endoscopic cervical foraminotomy, reported outcomes and/or complications for endoscopic cervical spine surgery relevant to the learning curve and had full-text. A random effects meta-analysis was performed for outcomes and complications. A total of three articles (n=203 patients) were included from 792 articles initially retrieved. The learning curves from four surgeons were examined with a frequency weighted mean 21 procedures until the competency phase. There was no significant difference in the postoperative hospitalization length (P=0.669), postoperative recovery room time (P=0.415), intraoperative blood loss (P=0.064), and total complication rates (10.9% vs. 1.2%, P=0.139) between endoscopic cervical foraminotomy procedures performed in the learning phase as compared to the competency phase of the learning curve. There was a significant decrease in operative time from the learning phase to the competency phase (P=0.005). Competency was achieved on the learning curve for endoscopic cervical foraminotomy after about 21 procedures. There is no significant difference in postoperative hospitalization time, postoperative recovery room time, intraoperative blood loss, and complication rates between the learning phase and the competency phase of the learning curve for endoscopic cervical foraminotomy, noting the relatively small sample size of this study that may underpower this finding.
Sections du résumé
STUDY DESIGN
METHODS
Systematic review and meta-analysis.
OBJECTIVE
OBJECTIVE
The objective of this study is to examine the impact of the learning curve for endoscopic cervical foraminotomy for clinical outcomes and patient safety.
SUMMARY OF BACKGROUND DATA
BACKGROUND
Endoscopic cervical foraminotomy is a minimally invasive surgical technique emerging in the literature for surgical management of cervical radiculopathy without the use of open incision. The adoption of endoscopic cervical foraminotomy may be hindered by the learning curve, although no review and meta-analysis exists to date on the topic.
METHODS
METHODS
A systematic review and meta-analysis was performed using PubMed, CINAHL, and MEDLINE from database inception until July 11th, 2023. Inclusion criteria were articles that examined endoscopic cervical foraminotomy, reported outcomes and/or complications for endoscopic cervical spine surgery relevant to the learning curve and had full-text. A random effects meta-analysis was performed for outcomes and complications.
RESULTS
RESULTS
A total of three articles (n=203 patients) were included from 792 articles initially retrieved. The learning curves from four surgeons were examined with a frequency weighted mean 21 procedures until the competency phase. There was no significant difference in the postoperative hospitalization length (P=0.669), postoperative recovery room time (P=0.415), intraoperative blood loss (P=0.064), and total complication rates (10.9% vs. 1.2%, P=0.139) between endoscopic cervical foraminotomy procedures performed in the learning phase as compared to the competency phase of the learning curve. There was a significant decrease in operative time from the learning phase to the competency phase (P=0.005).
CONCLUSION
CONCLUSIONS
Competency was achieved on the learning curve for endoscopic cervical foraminotomy after about 21 procedures. There is no significant difference in postoperative hospitalization time, postoperative recovery room time, intraoperative blood loss, and complication rates between the learning phase and the competency phase of the learning curve for endoscopic cervical foraminotomy, noting the relatively small sample size of this study that may underpower this finding.
Identifiants
pubmed: 37904547
doi: 10.1097/BRS.0000000000004859
pii: 00007632-990000000-00494
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: There are no conflicts of interest to disclose.