Learning curve of trans-sacral epiduroscopic laser decompression in herniated lumbar disc disease

• Published in: BMC surgery 2021-01, Vol.21 (1), p.39-39, Article 39
• Main Authors: Son, Seong, Yoo, Chan Jong, Yoo, Byung Rhae, Kim, Woo Seok, Jeong, Tae Seok
• Format: Article
• Language: English
• Subjects: Adult; Aged; Back pain; Clinical outcomes; Confidence intervals; Decompression; Decompression, Surgical - methods; Diagnostic imaging; Disc; Endoscopy; Epidural; Epidural Space - surgery; Failure rates; Familiarity; Female; Holmium; Humans; Intervertebral Disc Degeneration; Intervertebral Disc Displacement - diagnostic imaging; Intervertebral Disc Displacement - surgery; Intervertebral discs; Lasers; Learning; Learning Curve; Learning curves; Local anesthesia; Low back disorders; Low Back Pain - etiology; Lumbar spine; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - surgery; Magnetic resonance imaging; Male; Medical research; Medicine, Experimental; Middle Aged; Minimally invasive surgery; Operative Time; Patient satisfaction; Patients; Range of motion; Regression analysis; Retrospective Studies; Sacrum; Semiconductor lasers; Statistical analysis; Surgery; Surgical outcomes; Trans-sacral epiduroscopic laser decompression; Treatment Outcome; YAG lasers
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/s12893-020-00949-8

Trans-sacral epiduroscopic laser decompression (SELD) using slender epiduroscope and a holmium YAG laser is one of the minimally invasive surgical options for lumbar disc herniation. However, the learning curve of SELD and the effect of surgical proficiency on clinical outcome have not yet been established. We investigated patients with lumbar disc herniation undergoing SELD to report the clinical outcome and learning curve. Retrospective analysis of clinical outcome and learning curve were performed at a single center from clinical data collected from November 2015 to November 2018. A total of 82 patients who underwent single-level SELD for lumbar disc herniation with a minimum follow-up of 6.0 months were enrolled. Based on the findings that the cut-off of familiarity was 20 cases according to the cumulative study of operation time, patients were allocated to two groups: early group (n = 20) and late group (n = 62). The surgical, clinical, and radiological outcomes were retrospectively evaluated between the two groups to analyze the learning curve of SELD. According to linear and log regression analyses, the operation time was obtained by the formula: operation time = 58.825-(0.181 × [case number]) (p