Learning Curve of MIS-TLIF using 22 mm-tubular Retractor in Degenerative Spondylolisthesis (Grade 1-2) - A Review over 100 Cases
Objective To evaluate the learning curve of MIS-TLIF in degenerative spondylolisthesis with understanding of problems and challenges faced during initial cases. Methods After taken approval from institutional review board, first 109 patients who underwent MIS-TLIF for singlelevel low-grade degenerat...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Minimally Invasive Spine Surgery Society
2020-04-01
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| Series: | Journal of Minimally Invasive Spine Surgery and Technique |
| Subjects: | |
| Online Access: | http://www.jmisst.org/upload/pdf/jmisst-2019-00059.pdf |
| _version_ | 1797951363822387200 |
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| author | Rahul Pushpendra Mehta Ankit Subhash Patel Sanyam Jain Sameer Ruparel Neilakuo Kire Mihir Upadhyaya Rahul Prakash Singh Zahir Abbas Merchant Vishal Kundnani |
| author_facet | Rahul Pushpendra Mehta Ankit Subhash Patel Sanyam Jain Sameer Ruparel Neilakuo Kire Mihir Upadhyaya Rahul Prakash Singh Zahir Abbas Merchant Vishal Kundnani |
| author_sort | Rahul Pushpendra Mehta |
| collection | DOAJ |
| description | Objective To evaluate the learning curve of MIS-TLIF in degenerative spondylolisthesis with understanding of problems and challenges faced during initial cases. Methods After taken approval from institutional review board, first 109 patients who underwent MIS-TLIF for singlelevel low-grade degenerative spondylolisthesis between 2010 to 2015 were evaluated. First 100 cases that formed the study cohort at final follow-up were arranged sequentially in order of date of operation and then grouped in four quartiles. Comprehensive data which included demographics, clinical parameters, surgical parameters, peri-operative incidents (dural tear, technical issues like guide-wire migration, tube docking problems) and complications were assessed. Results Median operative time, median blood loss and median radiation exposure gradually decreased as the series progressed, however, showed statistically significant difference between Q1 and Q2 with no significant difference between later quartiles. There was a significant decline in postoperative VAS and ODI scores in all quartiles, however, there was no statistically significant difference in their values on comparison between quartiles. Guide-wire migration, dural tear and tube docking related problems, pedicle screw perforation significantly reduced after 1st quartile. Conclusion MIS-TLIF is safe and effective means of treating lumbar spondylolisthesis. The learning curve is achieved between 1st and 2nd quartile (25th to 50th cases). Familiarity with instrumentation, preoperative anatomical planning, better coordination with surgical team and hands-on tissue-training are keys to reduce the learning curve. |
| first_indexed | 2024-04-10T22:29:24Z |
| format | Article |
| id | doaj.art-29a4cf553d734199bf80f93379fc9781 |
| institution | Directory Open Access Journal |
| issn | 2508-2043 |
| language | English |
| last_indexed | 2024-04-10T22:29:24Z |
| publishDate | 2020-04-01 |
| publisher | Korean Minimally Invasive Spine Surgery Society |
| record_format | Article |
| series | Journal of Minimally Invasive Spine Surgery and Technique |
| spelling | doaj.art-29a4cf553d734199bf80f93379fc97812023-01-17T06:09:20ZengKorean Minimally Invasive Spine Surgery SocietyJournal of Minimally Invasive Spine Surgery and Technique2508-20432020-04-0151202510.21182/jmisst.2019.0005965Learning Curve of MIS-TLIF using 22 mm-tubular Retractor in Degenerative Spondylolisthesis (Grade 1-2) - A Review over 100 CasesRahul Pushpendra Mehta0Ankit Subhash Patel1Sanyam Jain2Sameer Ruparel3Neilakuo Kire4Mihir Upadhyaya5Rahul Prakash Singh6Zahir Abbas Merchant7Vishal Kundnani8 Department of Orthopedics & Spine Surgery, Bombay Hospital and Medical Research Center, Mumbai, India Department of Orthopedics & Spine Surgery, Bombay Hospital and Medical Research Center, Mumbai, India Department of Orthopedics & Spine Surgery, Bombay Hospital and Medical Research Center, Mumbai, India Department of Orthopedics & Spine Surgery, Bombay Hospital and Medical Research Center, Mumbai, India Department of Orthopedics & Spine Surgery, Bombay Hospital and Medical Research Center, Mumbai, India Department of Orthopedics & Spine Surgery, Bombay Hospital and Medical Research Center, Mumbai, India Department of Orthopedics & Spine Surgery, Bombay Hospital and Medical Research Center, Mumbai, India Department of Orthopedics & Spine Surgery, Bombay Hospital and Medical Research Center, Mumbai, India Department of Orthopedics & Spine Surgery, Bombay Hospital and Medical Research Center, Mumbai, IndiaObjective To evaluate the learning curve of MIS-TLIF in degenerative spondylolisthesis with understanding of problems and challenges faced during initial cases. Methods After taken approval from institutional review board, first 109 patients who underwent MIS-TLIF for singlelevel low-grade degenerative spondylolisthesis between 2010 to 2015 were evaluated. First 100 cases that formed the study cohort at final follow-up were arranged sequentially in order of date of operation and then grouped in four quartiles. Comprehensive data which included demographics, clinical parameters, surgical parameters, peri-operative incidents (dural tear, technical issues like guide-wire migration, tube docking problems) and complications were assessed. Results Median operative time, median blood loss and median radiation exposure gradually decreased as the series progressed, however, showed statistically significant difference between Q1 and Q2 with no significant difference between later quartiles. There was a significant decline in postoperative VAS and ODI scores in all quartiles, however, there was no statistically significant difference in their values on comparison between quartiles. Guide-wire migration, dural tear and tube docking related problems, pedicle screw perforation significantly reduced after 1st quartile. Conclusion MIS-TLIF is safe and effective means of treating lumbar spondylolisthesis. The learning curve is achieved between 1st and 2nd quartile (25th to 50th cases). Familiarity with instrumentation, preoperative anatomical planning, better coordination with surgical team and hands-on tissue-training are keys to reduce the learning curve.http://www.jmisst.org/upload/pdf/jmisst-2019-00059.pdflearning curveblood lossdegenerativeminimally invasive transforaminal lumbar interbody fusion (mistlif) |
| spellingShingle | Rahul Pushpendra Mehta Ankit Subhash Patel Sanyam Jain Sameer Ruparel Neilakuo Kire Mihir Upadhyaya Rahul Prakash Singh Zahir Abbas Merchant Vishal Kundnani Learning Curve of MIS-TLIF using 22 mm-tubular Retractor in Degenerative Spondylolisthesis (Grade 1-2) - A Review over 100 Cases Journal of Minimally Invasive Spine Surgery and Technique learning curve blood loss degenerative minimally invasive transforaminal lumbar interbody fusion (mistlif) |
| title | Learning Curve of MIS-TLIF using 22 mm-tubular Retractor in Degenerative Spondylolisthesis (Grade 1-2) - A Review over 100 Cases |
| title_full | Learning Curve of MIS-TLIF using 22 mm-tubular Retractor in Degenerative Spondylolisthesis (Grade 1-2) - A Review over 100 Cases |
| title_fullStr | Learning Curve of MIS-TLIF using 22 mm-tubular Retractor in Degenerative Spondylolisthesis (Grade 1-2) - A Review over 100 Cases |
| title_full_unstemmed | Learning Curve of MIS-TLIF using 22 mm-tubular Retractor in Degenerative Spondylolisthesis (Grade 1-2) - A Review over 100 Cases |
| title_short | Learning Curve of MIS-TLIF using 22 mm-tubular Retractor in Degenerative Spondylolisthesis (Grade 1-2) - A Review over 100 Cases |
| title_sort | learning curve of mis tlif using 22 mm tubular retractor in degenerative spondylolisthesis grade 1 2 a review over 100 cases |
| topic | learning curve blood loss degenerative minimally invasive transforaminal lumbar interbody fusion (mistlif) |
| url | http://www.jmisst.org/upload/pdf/jmisst-2019-00059.pdf |
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