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Characterizing the Surgeon Learning Curve in Instrumented Minimally Invasive Spinal Surgery: Does the Evidence
1Cooper Medical School of Rowan University, Camden, NJ.
Clinical Spine Surgery
|July 23, 2020
Summary
Studies on the learning curve for minimally invasive spine surgery (MIS) often lack sufficient detail on surgeon training and experience. Future research should adopt more robust methods to characterize surgeon proficiency for safer adoption of MIS techniques.
Area of Science:
- Spine surgery
- Surgical innovation
- Medical education
Background:
- Minimally invasive surgery (MIS) techniques offer benefits in spinal surgery, including reduced patient recovery times and improved outcomes.
- However, these techniques present significant technical demands on surgeons, particularly during the initial adoption phase (learning curve).
- Existing studies on MIS learning curves primarily focus on outcome metrics, with less attention to surgeon training and experience.
Purpose of the Study:
- To systematically review and aggregate evidence on the learning curve for instrumented MIS techniques in spinal surgery.
- To assess the extent to which surgeon training and experience are considered in existing learning curve studies.
Main Methods:
- A systematic literature review was conducted using PubMed and MEDLINE databases, adhering to PRISMA guidelines.
- Included articles were screened for any mention of surgeon experience or training.
- Statements on experience/training were categorized by the metrics used, and descriptive statistics were reported.
Main Results:
- Of 458 initially identified articles, 12 met the inclusion criteria.
- Seven articles (58.3%) included some mention of surgeon experience, utilizing metrics such as years in practice, prior experience with traditional techniques, or formal training.
- No studies incorporated surgeon experience as a quantitative variable in their analyses.
Conclusions:
- Current learning curve studies for instrumented spinal MIS procedures inadequately characterize surgeon experience and training.
- There is a need to adopt more comprehensive learning curve methodologies, similar to those used in other surgical specialties, to better evaluate surgeon proficiency.
