孔切开术
医学
外科
奇纳
荟萃分析
学习曲线
梅德林
内窥镜检查
并发症
减压
内科学
心理干预
管理
政治学
法学
经济
精神科
作者
Anthony N. Baumann,Megan E. Callaghan,Kempland C. Walley,Albert T. Anastasio,Aditya Muralidharan,Grayson M. Talaski,Brett Rocos
出处
期刊:Spine
[Ovid Technologies (Wolters Kluwer)]
日期:2023-10-31
卷期号:49 (7): 470-477
标识
DOI:10.1097/brs.0000000000004859
摘要
Study Design. A systematic review and meta-analysis. 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. 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. Materials and Methods. A systematic review and meta-analysis was performed using PubMed, CINAHL, and MEDLINE from database inception until July 11, 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. 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 FWM 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 with 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. 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.
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