Analysis of surgeon experience and impact of comorbidities on early discharge after mini-open transforaminal lumbar interbody fusion

Ferdinand J. Chan, Sarah Stelma, Woojin Cho, Jonathan Krystal, Alok D. Sharan

Research output: Contribution to journalArticle

Abstract

Background: Mini-open transforaminal lumbar interbody fusion (TLIF) has emerged as an alternative to open lumbar fusion. Currently, there is a limited amount of literature concerning the learning curve and perioperative variables of mini-open TLIF despite literature suggesting its overall advantage over open procedures. The objectives of this study were to evaluate the learning curve associated with mini-open TLIF and to identify factors affecting length of stay (LOS). Methods: Retrospective review of one surgeon's first 100 mini-open TLIF cases was performed to evaluate operative time, LOS, estimated blood loss (EBL), Oswestry Disability Index (ODI), visual analog pain scores (VAS), and fusion status. Operative time and LOS data were used to determine a proficiency point. Additional patient factors were collected and their impact on LOS was determined. Results: Operative time was found to be significantly less after 21 patients and LOS shorter after 22 patients. No significant differences were found when the first 22 patients were compared to the last 78 patients for ODI, VAS, and fusion status. Factors associated with decreased LOS include shorter operative time, lower EBL, later point on the learning curve of the surgeon, and patient factors including lower body mass index, being married or living with a significant other, and having a prior lumbar surgery. Conclusions: A significant learning curve is associated with mini-open TLIF. Similar follow-up outcomes suggest satisfactory outcomes even during the learning curve period.

Original languageEnglish (US)
Pages (from-to)382-387
Number of pages6
JournalCurrent Orthopaedic Practice
Volume27
Issue number4
DOIs
StatePublished - Jul 1 2016

Fingerprint

Learning Curve
Comorbidity
Length of Stay
Operative Time
Pain
Surgeons
Body Mass Index

Keywords

  • learning curve
  • length of stay
  • mini-open transforaminal lumbar interbody fusion (mini-open TLIF)
  • operative time
  • outcome

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Analysis of surgeon experience and impact of comorbidities on early discharge after mini-open transforaminal lumbar interbody fusion. / Chan, Ferdinand J.; Stelma, Sarah; Cho, Woojin; Krystal, Jonathan; Sharan, Alok D.

In: Current Orthopaedic Practice, Vol. 27, No. 4, 01.07.2016, p. 382-387.

Research output: Contribution to journalArticle

@article{fa80d8d5e5b848d282aa9ecfc987baef,
title = "Analysis of surgeon experience and impact of comorbidities on early discharge after mini-open transforaminal lumbar interbody fusion",
abstract = "Background: Mini-open transforaminal lumbar interbody fusion (TLIF) has emerged as an alternative to open lumbar fusion. Currently, there is a limited amount of literature concerning the learning curve and perioperative variables of mini-open TLIF despite literature suggesting its overall advantage over open procedures. The objectives of this study were to evaluate the learning curve associated with mini-open TLIF and to identify factors affecting length of stay (LOS). Methods: Retrospective review of one surgeon's first 100 mini-open TLIF cases was performed to evaluate operative time, LOS, estimated blood loss (EBL), Oswestry Disability Index (ODI), visual analog pain scores (VAS), and fusion status. Operative time and LOS data were used to determine a proficiency point. Additional patient factors were collected and their impact on LOS was determined. Results: Operative time was found to be significantly less after 21 patients and LOS shorter after 22 patients. No significant differences were found when the first 22 patients were compared to the last 78 patients for ODI, VAS, and fusion status. Factors associated with decreased LOS include shorter operative time, lower EBL, later point on the learning curve of the surgeon, and patient factors including lower body mass index, being married or living with a significant other, and having a prior lumbar surgery. Conclusions: A significant learning curve is associated with mini-open TLIF. Similar follow-up outcomes suggest satisfactory outcomes even during the learning curve period.",
keywords = "learning curve, length of stay, mini-open transforaminal lumbar interbody fusion (mini-open TLIF), operative time, outcome",
author = "Chan, {Ferdinand J.} and Sarah Stelma and Woojin Cho and Jonathan Krystal and Sharan, {Alok D.}",
year = "2016",
month = "7",
day = "1",
doi = "10.1097/BCO.0000000000000392",
language = "English (US)",
volume = "27",
pages = "382--387",
journal = "Current Orthopaedic Practice",
issn = "1940-7041",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Analysis of surgeon experience and impact of comorbidities on early discharge after mini-open transforaminal lumbar interbody fusion

AU - Chan, Ferdinand J.

AU - Stelma, Sarah

AU - Cho, Woojin

AU - Krystal, Jonathan

AU - Sharan, Alok D.

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Background: Mini-open transforaminal lumbar interbody fusion (TLIF) has emerged as an alternative to open lumbar fusion. Currently, there is a limited amount of literature concerning the learning curve and perioperative variables of mini-open TLIF despite literature suggesting its overall advantage over open procedures. The objectives of this study were to evaluate the learning curve associated with mini-open TLIF and to identify factors affecting length of stay (LOS). Methods: Retrospective review of one surgeon's first 100 mini-open TLIF cases was performed to evaluate operative time, LOS, estimated blood loss (EBL), Oswestry Disability Index (ODI), visual analog pain scores (VAS), and fusion status. Operative time and LOS data were used to determine a proficiency point. Additional patient factors were collected and their impact on LOS was determined. Results: Operative time was found to be significantly less after 21 patients and LOS shorter after 22 patients. No significant differences were found when the first 22 patients were compared to the last 78 patients for ODI, VAS, and fusion status. Factors associated with decreased LOS include shorter operative time, lower EBL, later point on the learning curve of the surgeon, and patient factors including lower body mass index, being married or living with a significant other, and having a prior lumbar surgery. Conclusions: A significant learning curve is associated with mini-open TLIF. Similar follow-up outcomes suggest satisfactory outcomes even during the learning curve period.

AB - Background: Mini-open transforaminal lumbar interbody fusion (TLIF) has emerged as an alternative to open lumbar fusion. Currently, there is a limited amount of literature concerning the learning curve and perioperative variables of mini-open TLIF despite literature suggesting its overall advantage over open procedures. The objectives of this study were to evaluate the learning curve associated with mini-open TLIF and to identify factors affecting length of stay (LOS). Methods: Retrospective review of one surgeon's first 100 mini-open TLIF cases was performed to evaluate operative time, LOS, estimated blood loss (EBL), Oswestry Disability Index (ODI), visual analog pain scores (VAS), and fusion status. Operative time and LOS data were used to determine a proficiency point. Additional patient factors were collected and their impact on LOS was determined. Results: Operative time was found to be significantly less after 21 patients and LOS shorter after 22 patients. No significant differences were found when the first 22 patients were compared to the last 78 patients for ODI, VAS, and fusion status. Factors associated with decreased LOS include shorter operative time, lower EBL, later point on the learning curve of the surgeon, and patient factors including lower body mass index, being married or living with a significant other, and having a prior lumbar surgery. Conclusions: A significant learning curve is associated with mini-open TLIF. Similar follow-up outcomes suggest satisfactory outcomes even during the learning curve period.

KW - learning curve

KW - length of stay

KW - mini-open transforaminal lumbar interbody fusion (mini-open TLIF)

KW - operative time

KW - outcome

UR - http://www.scopus.com/inward/record.url?scp=84978066196&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84978066196&partnerID=8YFLogxK

U2 - 10.1097/BCO.0000000000000392

DO - 10.1097/BCO.0000000000000392

M3 - Article

AN - SCOPUS:84978066196

VL - 27

SP - 382

EP - 387

JO - Current Orthopaedic Practice

JF - Current Orthopaedic Practice

SN - 1940-7041

IS - 4

ER -