Surgeons' Perspective, Learning Curve, Motivation, and Obstacles of Full-Endoscopic Spine Surgery in Thailand: Results From A Nationwide Survey.

Verapan Kuansongtham,Vit Kotheeranurak,Rattalerk Arunakul,Roongrath Chitragarn,Weerasak Singhatanadgige,Kai Uwe Lewandrowski,Suthipas Pongmanee,Narongsak Bamrungthin,Khanathip Jitpakdee,Worawat Limthongkul,Pritsanai Pruttikul,Monchai Ruangchainikom,Wongthawat Liawrungrueang,Saran Pairuchvej,Teerachat Tanasansomboon,Pornpavit Sriphirom,Gun Keorochana,Phanunan Sasiprapha

doi:10.1155/2022/4971844

Abstract

Objective To report a nationwide survey of the endoscopic spine surgeons across Thailand. Furthermore, the survey will be focused on the perspective of experience, learning curve, motivations, and obstacles at the beginning of their practices. Materials and Methods The online survey consisting of 16 items was distributed to spine surgeons who are performing endoscopic spine surgery in Thailand via the Google forms web-based questionnaire to investigate participants' demographics, backgrounds, experience in endoscopic spine surgery, motivations, obstacles, and future perspectives. The data was recorded from January 7, 2020 to January 21, 2022. Descriptive statistics were used for analysis. Results A total of 42 surveys were submitted by 6 neurosurgeons (14.3%) and 36 orthopedic surgeons (85.7%). From the surgeons' perspective, the average number of cases that should be performed until one feels confident, consistently good outcomes, and has minimal complications was 27.44 ± 32.46 cases. For surgeons who starting the endoscopic spine practice, at least 3 workshop participation is needed. Personal interest (39 selected responses) and trending marketing or business purpose (25 selected responses) were the primary motivators for endoscopic spine surgery implementation. Lack of support (18 selected responses) and afraid of complications (16 selected responses) were pertinent obstacles to endoscopic spine surgery implementation. Conclusions The trend of endoscopic spine surgery has continued to grow in Thailand, shown by the rate of implementation of endoscopic spine surgery reported by Thai spine surgeons. The number of appropriate cases until one feels confident was around 28 cases. The primary motivator and obstacles were personal interest and lack of support.

Highlights

Endoscopic spine surgery is being used to treat lumbar spine diseases across the world [1]
When compared to more traditional minimally invasive spine surgery (MISS) techniques, several randomized-controlled trials and meta-analyses have shown that patients undergoing spinal endoscopy for the treatment of lumbar stenosis, lumbar disc herniations, and cervical radiculopathy have similar outcomes [2–5]
Spine surgeons who are currently performing endoscopic spine surgery in Thailand were invited to participate in an online survey using a Google form web-based application

Summary

Introduction

Endoscopic spine surgery is being used to treat lumbar spine diseases across the world [1]. Full-endoscopic spine surgery is a common surgical procedure for treating lumbar disc herniation (LDH). When compared to more traditional MISS techniques, several randomized-controlled trials and meta-analyses have shown that patients undergoing spinal endoscopy for the treatment of lumbar stenosis, lumbar disc herniations, and cervical radiculopathy have similar outcomes [2–5]. This shifting trend, from more open to less invasive surgical techniques, is similar to what has happened in the past with laparoscopy and joint arthroscopy, where the patient would opt for less morbid operations and surgeon efforts to speed up postoperative recovery. The learning curve greatly varies depending on the treatment being performed [1, 7]

Methods

Results

Discussion

Conclusion