1.Evolving Paradigms in Spinal Surgery: A Systematic Review of the Learning Curves in Minimally Invasive Spine Techniques
Kun WU ; Zhihe YUN ; Siravich SUVITHAYASIRI ; Yihao LIANG ; Dimas Rahman SETIAWAN ; Vit KOTHEERANURAK ; Khanathip JITPAKDEE ; Enrico GIORDAN ; Qinyi LIU ; Jin-Sung KIM
Neurospine 2024;21(4):1251-1275
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.
2.Evolving Paradigms in Spinal Surgery: A Systematic Review of the Learning Curves in Minimally Invasive Spine Techniques
Kun WU ; Zhihe YUN ; Siravich SUVITHAYASIRI ; Yihao LIANG ; Dimas Rahman SETIAWAN ; Vit KOTHEERANURAK ; Khanathip JITPAKDEE ; Enrico GIORDAN ; Qinyi LIU ; Jin-Sung KIM
Neurospine 2024;21(4):1251-1275
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.
3.Evolving Paradigms in Spinal Surgery: A Systematic Review of the Learning Curves in Minimally Invasive Spine Techniques
Kun WU ; Zhihe YUN ; Siravich SUVITHAYASIRI ; Yihao LIANG ; Dimas Rahman SETIAWAN ; Vit KOTHEERANURAK ; Khanathip JITPAKDEE ; Enrico GIORDAN ; Qinyi LIU ; Jin-Sung KIM
Neurospine 2024;21(4):1251-1275
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.
4.Evolving Paradigms in Spinal Surgery: A Systematic Review of the Learning Curves in Minimally Invasive Spine Techniques
Kun WU ; Zhihe YUN ; Siravich SUVITHAYASIRI ; Yihao LIANG ; Dimas Rahman SETIAWAN ; Vit KOTHEERANURAK ; Khanathip JITPAKDEE ; Enrico GIORDAN ; Qinyi LIU ; Jin-Sung KIM
Neurospine 2024;21(4):1251-1275
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.
5.Evolving Paradigms in Spinal Surgery: A Systematic Review of the Learning Curves in Minimally Invasive Spine Techniques
Kun WU ; Zhihe YUN ; Siravich SUVITHAYASIRI ; Yihao LIANG ; Dimas Rahman SETIAWAN ; Vit KOTHEERANURAK ; Khanathip JITPAKDEE ; Enrico GIORDAN ; Qinyi LIU ; Jin-Sung KIM
Neurospine 2024;21(4):1251-1275
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.
6.The Italian Landscape of Spine Endoscopy: Are We Ready for the Challenges of the Future?
Letizia DELL’AGLIO ; Alessandro GRIECO ; Jacopo Del VERME ; Giuseppe CANOVA ; Roberto ZANATA ; Enrico GIORDAN
Journal of Minimally Invasive Spine Surgery and Technique 2024;9(Suppl 1):S77-S84
Objective:
Endoscopic spine surgery is gaining popularity, with efficacy comparable to that of traditional techniques. Apart from Germany, European countries are tentatively beginning to consider endoscopic surgery as a valid alternative to conventional procedures, and Italy is no exception. This survey aimed to reveal which spine surgeons currently use endoscopy in Italy, the levels of their skills, and how they have attained them.
Methods:
We conducted an online survey of Italian spinal surgeons to gather information about their use of minimally invasive and endoscopic surgery. We collected data on their operating habits, including the percentage of minimally invasive techniques in their practice, the type of workplace, and experience. We also asked surgeons to analyze and resolve 4 cases of degenerative lumbar pathologies.
Results:
Orthopedists and neurosurgeons in public and private facilities performed endoscopic surgery. One-third of respondents had never tried it, while others encountered it through workshops or producer presentations. A minority of interviewees considered themselves experts in endoscopic surgery, while more than half had “some” or “no” experience. Among endoscopic surgeons, none had experience in thoracic endoscopy, and only a few had used it for cervical diseases. The majority preferred a non-endoscopic approach when faced with clinical cases.
Conclusion
The use and knowledge of endoscopic surgery in Italy are not widespread. Our survey highlights a lack of training in the implementation of techniques that should be recognized as additional tools in addition to the traditional procedures for treating not only lumbar, but also thoracic and cervical pathologies.

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