Learning curve of biportal endoscopic unilateral laminotomy for bilateral decompression based on CUSUM analysis
LIN Liqun
HE Banglin
ZHU Zhicheng
SUN Jifu
SUN Yan
Abstract：Objective This retrospective study examined the clinical data of 73 patients diagnosed with lumbar spinal stenosis(LSS)to assess the learning curve and clinical outcomes of the unilateral approach for bilateral decompression(ULBD)procedure utilizing uniportal bilateral endoscopy(UBE).Methods The 73 patients in the Affiliated Hospital of Jiangsu University were analyzed as follows from June 2020 to June 2022 The surgical learning curve was divided into early and late groups using the cumulative summation(CUSUM)analysis method.Various parameters such as surgical time,Oswestry disability index(ODI)scores,back/lower extremity visual analogue scale(VAS)scores,and postoperative complications were compared between the two groups.Results Based on the inflection point of the learning curve,the 73 surgeries were divided into early and late groups.There were no statistically significant differences regarding general information,including age,gender,and duration of disease,between the two groups of LSS patients(P>0.05).The late group had a significantly lower mean operation time(73.28 min)than the early group(102.82 min),with a statistically significant difference(P<0.05).There were no significant differences in postoperative drainage volume and postoperative hospital stay between the two groups(P>0.05).Postoperative ODI scores and back/lower extremity VAS scores showed significant decreases compared with preoperative scores in all patients(P<0.05).However,there were no statistically significant differences in ODI scores and back/lower extremity VAS scores between the early and late groups(P>0.05).The incidence of postoperative complications was lower in the late group(2.5%)compared with the early group(8.8%),although the difference was not statistically significant(P>0.05).Conclusion The learning curve for ULBD surgery utilizing UBE exhibits an inflection point at the 34 th operation as determined by CUSUM analysis.Both the early and late groups of patients can achieve favorable clinical outcomes.
Keywords：lumbar spinal stenosisunilateral approach for bilateral decompressionuniportal bilateral endoscopyCUSUM
Publication Date：2023-10-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 12-16 )