{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,3,23]],"date-time":"2024-03-23T01:22:03Z","timestamp":1711156923216},"reference-count":12,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Learning curves (LC) are typically defined by the number of different spinal procedures surgeons must perform before becoming \u201cproficient,\u201d as demonstrated by reductions in operative times, estimated blood loss (EBL), length of hospital stay (LOS), adverse events (AE), fewer conversions to open procedures, along with improved outcomes. Reviewing 12 studies revealed LC varied widely from 10-44 cases for open vs. minimally invasive (MI) lumbar diskectomy, laminectomy, transforaminal lumbar interbody fusion (TLIF), anterior lumbar interbody fusion (ALIF), and oblique\/extreme lateral interbody fusions (OLIF\/XLIF). We asked whether the risks of harm occurring during these LC could be limited if surgeons routinely utilized in-person\/intraoperative mentoring (i.e., via industry, academia, or well-trained colleagues).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>We evaluated LC for multiple lumbar operations in 12 studies.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>These studies revealed no LC for open vs. MI lumbar diskectomy. LC required 29 cases for MI laminectomy, 10-44 cases for MI TLIF, 24-30 cases for MI OLIF, and 30 cases for XLIF. Additionally, the LC for MI ALIF was 30 cases; one study showed that 32% of major vascular injuries occurred in the first 25 vs. 0% for the next 25 cases. Shouldn\u2019t the risks of harm to patients occurring during these LC be limited if surgeons routinely utilized in-person\/intraoperative mentoring?<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusions: <\/jats:title>\n<jats:p>Twelve studies showed that the LC for at different MI lumbar spine operations varied markedly (i.e., 10-44 cases). Wouldn\u2019t and shouldn\u2019t spine surgeons avail themselves of routine in-person\/intraoperative mentoring to limit patients\u2019 risks of injury during their respective LC for these varied spine procedures ?<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_119_2024","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T10:13:11Z","timestamp":1711102391000},"page":"97","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perspective: How can risks to patients be limited during spine surgeons\u2019 learning curves?"],"prefix":"10.25259","volume":"15","author":[{"given":"Nancy E.","family":"Epstein","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2024,3,22]]},"reference":[{"key":"10.25259\/SNI_119_2024\/ref-1","doi-asserted-by":"crossref","first-page":"3551","DOI":"10.1007\/s00586-022-07397-3","article-title":"Learning curve for minimally invasive transforaminal lumbar interbody fusion: A systematic review","volume":"31","author":"Ahn","year":"2022","journal-title":"Eur Spine J"},{"key":"10.25259\/SNI_119_2024\/ref-2","doi-asserted-by":"crossref","first-page":"61","DOI":"10.4103\/sni.sni_39_17","article-title":"Learning curves for minimally invasive spine surgeries: Are they worth it?","volume":"8","author":"Epstein","year":"2017","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_119_2024\/ref-3","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1097\/BSD.0000000000001052","article-title":"Characterizing the surgeon learning curve in instrumented minimally invasive spinal surgery: Does the evidence account for training and experience? 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