Neurospine.  2024 Dec;21(4):1251-1275. 10.14245/ns.2448838.419.

Evolving Paradigms in Spinal Surgery: A Systematic Review of the Learning Curves in Minimally Invasive Spine Techniques

• Wu K
• Yun Z
• Suvithayasiri S
• Liang Y
• Setiawan DR
• Kotheeranurak V
• Jitpakdee K
• Giordan E
• Liu Q
• Kim JS

• KMID: 2563124
• DOI: http://doi.org/10.14245/ns.2448838.419

Abstract

Our research examines the learning curves of various minimally invasive lumbar surgeries to determine the benefits and challenges they pose to both surgeons and patients. The advent of microsurgical techniques since the 1960s, including advances in fluoroscopic navigation and intraoperative computed tomography, has significantly shifted spinal surgery from open to minimally invasive methods. This study critically evaluates surgical duration, intraoperative conversions to open surgery, and complications as primary parameters to gauge these learning curves. Through a comprehensive literature search up to March 2024, involving databases PubMed, Cochrane Library, and Web of Science, this paper identifies a steep learning curve associated with these surgeries. Despite their proven advantages in reducing recovery time and surgical trauma, these procedures require surgeons to master advanced technology and equipment, which can directly impact patient outcomes. The study underscores the need for well-defined learning curves to facilitate efficient training and enhance surgical proficiency, especially for novice surgeons. Moreover, it addresses the implications of technology on surgical accuracy and the subsequent effects on complication rates, providing insights into the complex dynamics of adopting new surgical innovations in spinal health care.

Keyword

Minimally invasive surgical procedures; Spine; Learning curve; Complications