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CLC number: R681.5+7

On-line Access: 2016-07-06

Received: 2016-01-01

Revision Accepted: 2016-03-08

Crosschecked: 2016-06-23

Cited: 3

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Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

Xin-bo Wu

http://orcid.org/0000-0002-9846-2857

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Journal of Zhejiang University SCIENCE B 2016 Vol.17 No.7 P.553-560

http://doi.org/10.1631/jzus.B1600002


Learning curves of percutaneous endoscopic lumbar discectomy in transforaminal approach at the L4/5 and L5/S1 levels: a comparative study


Author(s):  Xin-bo Wu, Guo-xin Fan, Xin Gu, Tu-gang Shen, Xiao-fei Guan, An-nan Hu, Hai-long Zhang, Shi-sheng He

Affiliation(s):  Orthopedic Department, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, China; more

Corresponding email(s):   guxin2004ty@163.com, tjhss7418@foxmail.com

Key Words:  Learning curve, Percutaneous endoscopic lumbar discectomy, Transforaminal approach


Xin-bo Wu, Guo-xin Fan, Xin Gu, Tu-gang Shen, Xiao-fei Guan, An-nan Hu, Hai-long Zhang, Shi-sheng He. Learning curves of percutaneous endoscopic lumbar discectomy in transforaminal approach at the L4/5 and L5/S1 levels: a comparative study[J]. Journal of Zhejiang University Science B, 2016, 17(7): 553-560.

@article{title="Learning curves of percutaneous endoscopic lumbar discectomy in transforaminal approach at the L4/5 and L5/S1 levels: a comparative study",
author="Xin-bo Wu, Guo-xin Fan, Xin Gu, Tu-gang Shen, Xiao-fei Guan, An-nan Hu, Hai-long Zhang, Shi-sheng He",
journal="Journal of Zhejiang University Science B",
volume="17",
number="7",
pages="553-560",
year="2016",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1600002"
}

%0 Journal Article
%T Learning curves of percutaneous endoscopic lumbar discectomy in transforaminal approach at the L4/5 and L5/S1 levels: a comparative study
%A Xin-bo Wu
%A Guo-xin Fan
%A Xin Gu
%A Tu-gang Shen
%A Xiao-fei Guan
%A An-nan Hu
%A Hai-long Zhang
%A Shi-sheng He
%J Journal of Zhejiang University SCIENCE B
%V 17
%N 7
%P 553-560
%@ 1673-1581
%D 2016
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1600002

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T1 - Learning curves of percutaneous endoscopic lumbar discectomy in transforaminal approach at the L4/5 and L5/S1 levels: a comparative study
A1 - Xin-bo Wu
A1 - Guo-xin Fan
A1 - Xin Gu
A1 - Tu-gang Shen
A1 - Xiao-fei Guan
A1 - An-nan Hu
A1 - Hai-long Zhang
A1 - Shi-sheng He
J0 - Journal of Zhejiang University Science B
VL - 17
IS - 7
SP - 553
EP - 560
%@ 1673-1581
Y1 - 2016
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1600002


Abstract: 
Objectives: This study aimed to compare the learning curves of percutaneous endoscopic lumbar discectomy (PELD) in a transforaminal approach at the L4/5 and L5/S1 levels. Methods: We retrospectively reviewed the first 60 cases at the L4/5 level (Group I) and the first 60 cases at the L5/S1 level (Group II) of PELD performed by one spine surgeon. The patients were divided into subgroups A, B, and C (Group I: A cases 1–20, B cases 21–40, C cases 41–60; Group II: A cases 1–20, B cases 21–40, C cases 41–60). Operation time was thoroughly analyzed. Results: Compared with the L4/5 level, the learning curve of transforaminal PELD at the L5/S1 level was flatter. The mean operation times of Groups IA, IB, and IC were (88.75±17.02), (67.75±6.16), and (64.85±7.82) min, respectively. There was a significant difference between Groups A and B (P<0.05), but no significant difference between Groups B and C (P=0.20). The mean operation times of Groups IIA, IIB, and IIC were (117.25±13.62), (109.50±11.20), and (92.15±11.94) min, respectively. There was no significant difference between Groups A and B (P=0.06), but there was a significant difference between Groups B and C (P<0.05). There were 6 cases of postoperative dysesthesia (POD) in Group I and 2 cases in Group IIA (P=0.27). There were 2 cases of residual disc in Group I, and 4 cases in Group II (P=0.67). There were 3 cases of recurrence in Group I, and 2 cases in Group II (P>0.05). Conclusions: Compared with the L5/S1 level, the learning curve of PELD in a transforaminal approach at the L4/5 level was steeper, suggesting that the L4/5 level might be easier to master after short-term professional training.

经皮椎间孔镜治疗腰4/5和腰5骶1椎间盘突出症学习曲线的比较研究

目的:探讨经皮椎间孔镜技术治疗腰4/5和腰5骶1椎间盘突出症学习曲线之间的差异。
创新点:本文第一次比较了经皮椎间孔镜治疗腰4/5和腰5/骶1椎间盘突出症的学习曲线,得出经皮椎间孔镜治疗腰4/5椎间盘突出症的学习曲线更加陡峭,经过专业化培训更加容易掌握,为初学者提供了指导方向。
方法:回顾性分析2011年6月至2013年8月于上海市第十人民医院行经皮椎间孔镜治疗的120例腰4/5和腰5骶1椎间盘突出症患者的临床资料。120例患者由同一术者实行手术操作,根据突出节段不同分为两组:腰4/5组(组I)60例和腰5骶1组(组II)60例。每组又分成三个亚组:组IA 1~20、IB 21~40、IC 41~60;组IIA 1~20、IIB 21~40、IIC 41~60。分别记录每位患者的手术时间。
结论:实验结果显示:组IA、IB、IC平均手术时间 分别为(88.75±17.02)、(67.75±6.16)和(64.85±7.82) min,组IA与组IB之间的差异有统计学意义,组IB与组IC之间的差异无统计学意义;组IIA、IIB、IIC平均手术时间分别为(117.25±13.62)、(109.50±11.20)和(92.15±11.94) min,组IIA与组IIB之间的差异无统计学意义,组IIB与组IIC之间的差异有统计学意义。术后8例患者出现术后感觉减退(POD),其中组I有6例,组II有2例。术后磁共振成像(MRI)检查有6例患者有椎间盘残留,其中组I有2例,组II有4例。术后随访5例患者复发,其中组I有3例,组II有2例,但差异无统计学意义。与腰5骶1学习曲线相比,经皮椎间孔镜治疗腰4/5椎间盘突出的学习曲线更加陡峭,经过专业化培训更加容易掌握。

关键词:学习曲线;经皮;椎间孔镜;腰椎间盘突出

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

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