Learning curve analysis of unilateral biportal endoscopic lumbar interbody fusion_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Ning ¹ , BEI Chaoyong ² , WAN Jian ¹ ,  WANG Honggang ¹

1. Department of Spine Surgery, Affiliated Hospital of Guilin Medical College, Guilin Guangxi, 541000, P. R. China;
2. Department of Trauma Surgery, Affiliated Hospital of Guilin Medical College, Guilin Guangxi, 541000, P. R. China;

Corresponding?author：

WANG Honggang, Email: whg_81@163.com

Keywords：

Unilateral biportal endoscopy technique; posterior lumbar decompression and fusion; learning curve

DOI：

10.7507/1002-1892.202205139

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the learning curve of unilateral biportal endoscopic lumbar interbody fusion (UBE-LIF). Methods Fifty-five patients with single-segment lumbar degenerative disease treated with UBE-LIF between December 2020 and February 2022 were selected as the research subjects. The patients were grouped according to the operation sequence, the first 27 cases were in the early group, and the last 28 cases were in the late group. There was no significant difference between the two groups in age, gender, disease type, and surgical segment distribution (P>0.05). The operation time, the amount of hemoglobin loss (the difference between 1 day before operation and 3 days after operation), the hospital stay after operation, and the incidence of perioperative complications were recorded; the learning curve of UBE-LIF was analyzed by log-curve regression analysis. Results All the operations were successfully completed without changing to other operations. The operation time, the amount of hemoglobin loss, and hospital stay in the early group were significantly more than those in the late group (P<0.05). Complications occurred in 2 cases (7.4%) in the early group, including 1 case of dural tear during operation and 1 case of epidural hematoma after operation, and 1 case (3.6%) with transient radiculitis in the late group. There was no significant difference in the incidence of complications between the two groups (P=0.518) . The log-curve regression analysis showed that the operation time decreased significantly with the increase of the number of patients (P<0.05). The operation time tended to be stable after the surgeon completed 17 cases. Conclusion For single-level lumbar degenerative disease, the operation time of UBE-LIF can decrease gradually with the increase of the number of patients, and tend to be stable after 17 cases.

Citation： WANG Ning, BEI Chaoyong, WAN Jian, WANG Honggang. Learning curve analysis of unilateral biportal endoscopic lumbar interbody fusion. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(10): 1229-1233. doi: 10.7507/1002-1892.202205139 Copy

1.	Katz JN, Harris MB. Clinical practice. Lumbar spinal stenosis. N Engl J Med, 2008, 358(8): 818-825.
2.	Phillips FM, Slosar PJ, Youssef JA, et al. Lumbar spine fusion for chronic low back pain due to degenerative disc disease: a systematic review. Spine (Phila Pa 1976), 2013, 38(7): E409-E422.
3.	姜樂濤, 杜建偉. 腰椎管狹窄癥的治療進展. 局解手術學雜志, 2021, 30(11): 1012-1017.
4.	Hari A, Krishna M, Rajagandhi S, et al. Minimally invasive transforaminal lumbar interbody fusion-indications and clinical experience. Neurol India, 2016, 64(3): 444-454.
5.	鐘睿, 王潤生, 劉建恒, 等. 不同入路微創經椎間孔腰椎間融合術治療單節段腰椎管狹窄癥的療效比較. 中國修復重建外科雜志, 2019, 33(7): 807-813.
6.	Kim JE, Yoo HS, Choi DJ, et al. Comparison of minimal invasive versus biportal endoscopic transforaminal lumbar interbody fusion for single-level lumbar disease. Clin Spine Surg, 2021, 34(2): E64-E71.
7.	汪文龍, 劉正, 吳四軍, 等. 單側雙通道內鏡下減壓治療腰椎管狹窄癥的早期療效觀察. 中國脊柱脊髓雜志, 2021, 31(10): 911-918.
8.	田大勝, 劉建軍, 朱斌, 等. 單邊雙通道內鏡技術治療腰椎間盤突出癥和腰椎椎管狹窄癥. 中華骨科雜志, 2020, 40(17): 1155-1164.
9.	張偉, 黨晨珀, 姚彥斌, 等. 單側雙通道脊柱內鏡治療腰椎間盤突出癥的臨床療效. 西北國防醫學雜志, 2021, 42(5): 341-346.
10.	Heo DH, Hong YH, Lee DC, et al. Technique of biportal endoscopic transforaminal lumbar interbody fusion. Neurospine, 2020, 17(Suppl 1): S129-S137.
11.	朱斌, 田大勝, 陳磊, 等. 單邊雙通道內鏡技術在腰椎疾病中的應用研究進展. 中華骨科雜志, 2020, 40(15): 1030-1038.
12.	Heo DH, Son SK, Eum JH, et al. Fully endoscopic lumbar interbody fusion using a percutaneous unilateral biportal endoscopic technique: technical note and preliminary clinical results. Neurosurg Focus, 2017, 43(2): E8. doi: 10.3171/2017.5.FOCUS17146.
13.	李佳奇, 王林峰, 高顯達, 等. MIS-TLIF治療腰椎退變性疾病的研究進展. 中國矯形外科雜志, 2018, 26(7): 631-634.
14.	Park SM, Kim GU, Kim HJ, et al. Is the use of a unilateral biportal endoscopic approach associated with rapid recovery after lumbar decompressive laminectomy? A preliminary analysis of a prospective randomized controlled trial. World Neurosurg, 2019, 128: e709-e718.
15.	Jubbal KT, Chang D, Izaddoost SA, et al. Resident involvement in microsurgery: An American college of surgeons national surgical quality improvement program analysis. J Surg Educ, 2017, 74(6): 1124-1132.
16.	鄭超, 劉俊朋, 馬煒, 等. 三角技術在脊柱單側雙通道內鏡手術中的應用: 38例臨床病例比較研究. 空軍醫學雜志, 2021, 37(5): 413-417.
17.	王彬, 武振方. 單側雙通道脊柱內鏡技術并發癥及處理的研究進展. 醫學研究生學報, 2021, 34(7): 756-760.
18.	Park MK, Park SA, Son SK, et al. Correction to: Clinical and radiological outcomes of unilateral biportal endoscopic lumbar interbody fusion (ULIF) compared with conventional posterior lumbar interbody fusion (PLIF): 1-year follow-up. Neurosurg Rev, 2019, 42(3): 763. doi: 10.1007/s10143-019-01131-2.
19.	Zhang H. Letter to the Editor concerning “A less invasive surgical approach in the lumbar lateral recess stenosis: direct approach to the medial wall of the pedicle” by A Colak et al. (2008) Eur Spine J; 17: 1745-1751. Eur Spine J, 2015, 24(6): 1324-1325.

1. Katz JN, Harris MB. Clinical practice. Lumbar spinal stenosis. N Engl J Med, 2008, 358(8): 818-825.
2. Phillips FM, Slosar PJ, Youssef JA, et al. Lumbar spine fusion for chronic low back pain due to degenerative disc disease: a systematic review. Spine (Phila Pa 1976), 2013, 38(7): E409-E422.
3. 姜樂濤, 杜建偉. 腰椎管狹窄癥的治療進展. 局解手術學雜志, 2021, 30(11): 1012-1017.
4. Hari A, Krishna M, Rajagandhi S, et al. Minimally invasive transforaminal lumbar interbody fusion-indications and clinical experience. Neurol India, 2016, 64(3): 444-454.
5. 鐘睿, 王潤生, 劉建恒, 等. 不同入路微創經椎間孔腰椎間融合術治療單節段腰椎管狹窄癥的療效比較. 中國修復重建外科雜志, 2019, 33(7): 807-813.
6. Kim JE, Yoo HS, Choi DJ, et al. Comparison of minimal invasive versus biportal endoscopic transforaminal lumbar interbody fusion for single-level lumbar disease. Clin Spine Surg, 2021, 34(2): E64-E71.
7. 汪文龍, 劉正, 吳四軍, 等. 單側雙通道內鏡下減壓治療腰椎管狹窄癥的早期療效觀察. 中國脊柱脊髓雜志, 2021, 31(10): 911-918.
8. 田大勝, 劉建軍, 朱斌, 等. 單邊雙通道內鏡技術治療腰椎間盤突出癥和腰椎椎管狹窄癥. 中華骨科雜志, 2020, 40(17): 1155-1164.
9. 張偉, 黨晨珀, 姚彥斌, 等. 單側雙通道脊柱內鏡治療腰椎間盤突出癥的臨床療效. 西北國防醫學雜志, 2021, 42(5): 341-346.
10. Heo DH, Hong YH, Lee DC, et al. Technique of biportal endoscopic transforaminal lumbar interbody fusion. Neurospine, 2020, 17(Suppl 1): S129-S137.
11. 朱斌, 田大勝, 陳磊, 等. 單邊雙通道內鏡技術在腰椎疾病中的應用研究進展. 中華骨科雜志, 2020, 40(15): 1030-1038.
12. Heo DH, Son SK, Eum JH, et al. Fully endoscopic lumbar interbody fusion using a percutaneous unilateral biportal endoscopic technique: technical note and preliminary clinical results. Neurosurg Focus, 2017, 43(2): E8. doi: 10.3171/2017.5.FOCUS17146.
13. 李佳奇, 王林峰, 高顯達, 等. MIS-TLIF治療腰椎退變性疾病的研究進展. 中國矯形外科雜志, 2018, 26(7): 631-634.
14. Park SM, Kim GU, Kim HJ, et al. Is the use of a unilateral biportal endoscopic approach associated with rapid recovery after lumbar decompressive laminectomy? A preliminary analysis of a prospective randomized controlled trial. World Neurosurg, 2019, 128: e709-e718.
15. Jubbal KT, Chang D, Izaddoost SA, et al. Resident involvement in microsurgery: An American college of surgeons national surgical quality improvement program analysis. J Surg Educ, 2017, 74(6): 1124-1132.
16. 鄭超, 劉俊朋, 馬煒, 等. 三角技術在脊柱單側雙通道內鏡手術中的應用: 38例臨床病例比較研究. 空軍醫學雜志, 2021, 37(5): 413-417.
17. 王彬, 武振方. 單側雙通道脊柱內鏡技術并發癥及處理的研究進展. 醫學研究生學報, 2021, 34(7): 756-760.
18. Park MK, Park SA, Son SK, et al. Correction to: Clinical and radiological outcomes of unilateral biportal endoscopic lumbar interbody fusion (ULIF) compared with conventional posterior lumbar interbody fusion (PLIF): 1-year follow-up. Neurosurg Rev, 2019, 42(3): 763. doi: 10.1007/s10143-019-01131-2.
19. Zhang H. Letter to the Editor concerning “A less invasive surgical approach in the lumbar lateral recess stenosis: direct approach to the medial wall of the pedicle” by A Colak et al. (2008) Eur Spine J; 17: 1745-1751. Eur Spine J, 2015, 24(6): 1324-1325.

Chinese Journal of Reparative and Reconstructive Surgery

Learning curve analysis of unilateral biportal endoscopic lumbar interbody fusion

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content