Learning Curve of Percutaneous Endoscopic Lumbar Discectomy Based on the Period (Early vs. Late) and Technique (in-and-out vs. in-and-out-and-in): A Retrospective Comparative Study
Journal of Korean Neurosurgical Society
;
: 539-546, 2015.
Article
in English
| WPRIM
| ID: wpr-204840
ABSTRACT
OBJECTIVE:
To report the learning curve of percutaneous endoscopic lumbar discectomy (PELD) for a surgeon who had not been previously exposed to this procedure based on the period and detailed technique with a retrospective matched comparative design.METHODS:
Of 213 patients with lumbar disc herniation encountered during the reference period, 35 patients who were followed up for 1 year after PELD were enrolled in this study. The patients were categorized by the period and technique of operation group A, the first 15 cases, who underwent by the 'in-and-out' technique; group B, the next 20 cases, who underwent by the 'in-and-out-and-in' technique. The operation time, failure rate, blood loss, complication rate, re-herniation rate, the Visual Analogue Scale (VAS) for back and leg were checked. The alteration of dural sac cross-sectional area (DSCSA) between the preoperative and the postoperative MRI was checked.RESULTS:
Operative time was rapidly reduced in the early phase, and then tapered to a steady state for the 35 cases receiving the PELD. After surgery, VAS scores for the back and leg were decreased significantly in both groups. Complications occurred in 2 patients in group A and 2 patients in group B. Between the two groups, there were significant differences in operative time, improvement of leg VAS, and expansion of DSCSA.CONCLUSION:
PELD learning curve seems to be acceptable with sufficient preparation. However, because of their high tendency to delayed operation time, operation failure, and re-herniation, caution should be exercised at the early phase of the procedure.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Magnetic Resonance Imaging
/
Retrospective Studies
/
Diskectomy
/
Learning Curve
/
Operative Time
/
Learning
/
Leg
Type of study:
Observational study
Limits:
Humans
Language:
English
Journal:
Journal of Korean Neurosurgical Society
Year:
2015
Type:
Article
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