Abstract
ObjectiveMany studies on the clinical outcome of full endoscopic spine surgery versus open spine surgery have been published. However, only a few studies have compared the learning curves of percutaneous endoscopic interlaminar lumbar discectomy (PEILD) and open lumbar microdiscectomy (OLM) at the L5–S1 level. This study included patients with disc herniation at the L5–S1 level, who underwent PEILD or OLM performed by a single novice surgeon and compared the learning curves.MethodsFifty-six patients who underwent PEILD or OLM at the L5–S1 level and completed a minimum 1-year follow-up were enrolled in the study. The patients were allocated to the PEILD group (n = 27, September 2014 to August 2016) or an OLM group (n = 29, September 2012 to August 2014). The learning curves were retrospectively compared based on operation time and surgical outcomes, including complication, failure, and recurrence rates were retrospectively compared.ResultsSignificant intergroup differences were not noted with respect to the baseline characteristics, including age, sex, body mass index, preoperative symptoms, or preoperative radiological findings. The mean operation time was significantly shorter in the PEILD group than in the OLM group (63.89±17.99 min versus 78.03±19.01 min, p = 0.006). Based on the operation time according to the number of cases, the learning curve was more difficult in the PEILD group according to the cumulative analysis (case number cut-off for proficiency was 18 in the PEILD group versus 10 in the OLM group) and linear regression analysis (proportionality constant for decrease in the operation time was -0.922 in the PEILD group versus -1.738 in the OLM group) than that in the OLM group. However, the surgical outcomes, including failure, surgical efficacy based on nerve root decompression, complication, and recurrence rates did not differ between the two groups.ConclusionAlthough the learning curve of PEILD was more difficult than that of OLM, the mean operation time was shorter in the PEILD group than that in the OLM group. Moreover, based on the surgical outcomes, PEILD showed efficacy and safety similar to those of OLM.
Highlights
Open lumbar microdiscectomy (OLM) has been a standard surgical technique for the treatment of lumbar disc herniation owing to its efficacy and safety, since the late 1907s [1,2,3,4,5,6]
The mean operation time was significantly shorter in the percutaneous endoscopic interlaminar lumbar discectomy (PEILD) group than in the OLM group (63.89±17.99 min versus 78.03±19.01 min, p = 0.006)
Based on the operation time according to the number of cases, the learning curve was more difficult in the PEILD group according to the cumulative analysis and linear regression analysis than that in the OLM group
Summary
Open lumbar microdiscectomy (OLM) has been a standard surgical technique for the treatment of lumbar disc herniation owing to its efficacy and safety, since the late 1907s [1,2,3,4,5,6]. Percutaneous endoscopic interlaminar lumbar discectomy (PEILD) has gained popularity worldwide, as a standard full-endoscopic surgical technique for the treatment of disc herniation at the L5–S1 level and as an alternative minimally invasive technique to OLM since the mid-2000s [7]. Many previous studies have reported on the efficacy and safety of PEILD [8,9,10,11,12,13,14]. The major concerns regarding full endoscopic surgery include a steep learning curve, fear of failure, complications, and recurrence after surgery, if the surgeon is in the novice stage
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
