2022 Volume 13 Issue 8 Pages 1044-1048
Introduction: There is a learning curve in spinal endoscopy, which is a major obstacle in learning spinal endoscopy. In this article, we present the learning curve of cases performed without direct supervision after 5 months of short-term training at a spine endoscopy training facility, divided into endoscopic discectomy (MED) and endoscopic laminectomy (MEL), and present the experience of a single surgeon initiating spinal endoscopic surgery.
Subjects and Methods: The subject was orthopedic surgeon who had been licensed as a physician for 10 years and an orthopedic surgeon for 4 years. After performing spinal surgery (non-endoscopic surgery) in about 130 cases, he conducted a short-term training, he observed about 90 cases of spinal endoscopic surgery, and experienced 19 cases. Fifty-two spine endoscopic surgeries (MED 15 cases, MEL 37 cases) performed during the 9-month period immediately following the end of training were included in the study, and operative time, blood loss, JOA score improvement rate, and complications were examined.
Results: The mean operative time for MED was 62 minutes, the mean blood loss was 11.3 ml, and the mean JOA score improvement rate was 77.1%. There was no learning curve and no complications. The mean operative time for MEL was 69 minutes, the mean blood loss was 9.3 ml, and the mean JOA score improvement rate was 66.9%. The operative time showed a learning curve in the initial 14 cases, and we experienced complications of dural injury in the 18th case and a wrong-site surgery in the 35th case.
Conclusion: The learning curve of single-operator spinal endoscopic surgery performed after short-term training in spinal endoscopy is presented. Short-term training contributed to good surgical outcomes and avoidance or shortening of the learning curve.
