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The Surgical Learning Curve for Cervical Disk Replacement.

Vincent P Federico1, James W Nie, Timothy J Hartman

  • 1Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.

Clinical Spine Surgery
|September 9, 2023
PubMed
Summary
This summary is machine-generated.

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An experienced spine surgeon

Area of Science:

  • Spine surgery
  • Cervical disk replacement
  • Surgical learning curves

Background:

  • A surgeon's learning curve for cervical disk replacement (CDR) is not well-established.
  • Understanding this curve is crucial for optimizing patient outcomes and surgical efficiency.

Purpose of the Study:

  • To characterize the learning curve of a single, experienced spine surgeon performing CDR.
  • To identify distinct phases (learning, practicing, mastery) and their associated outcomes.

Main Methods:

  • Retrospective analysis of 173 patients undergoing CDR by a single surgeon.
  • Operative time cumulative sum used to define learning, practicing, and mastery phases.
  • Collected data included demographics, perioperative factors, complications, patient-reported outcomes (PROs), and radiographic measures.

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Main Results:

  • The learning phase comprised 14 patients, characterized by longer operative times and higher narcotic consumption.
  • Patients in the learning phase reported worse arm pain scores (Visual Analog Scale) postoperatively.
  • No significant radiographic differences were observed between the phases at final follow-up.

Conclusions:

  • The learning phase for experienced surgeons in CDR is approximately 14 cases.
  • Despite initial inefficiencies, CDR can be performed safely with comparable outcomes by experienced surgeons.
  • Patient outcomes, particularly arm pain, showed improvement differences during the learning phase.