Impact of Arthroscopic Experience on the Learning Curve in Interlaminar Endoscopic Lumbar Discectomy: A Single-Center Prospective Cohort Study of 240 Patients Article Swipe
Tomasz Sienkiel
,
Marcin Gąska
,
Przemysław Koszyk
,
Ewa Lipik
,
Barbara Jasiewicz
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.21203/rs.3.rs-8099529/v1
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.21203/rs.3.rs-8099529/v1
Study Design: Prospective single-center observational cohort study. Objectives: To evaluate whether prior arthroscopic experience shortens the learning curve in interlaminar endoscopic lumbar discectomy (IELD) and influences complication rates and patient-reported outcomes (PROs). Methods: In accordance with STROBE guidelines, 240 consecutive patients with single-level lumbar disc herniation (MSU A/B, non-calcified, symptom duration ≤ 3 months) underwent IELD between 2021 and 2023 at the University Orthopedic and Rehabilitation Hospital in Zakopane, affiliated with the Department and Clinic of Orthopedics and Rehabilitation, Collegium Medicum, Jagiellonian University. Procedures were performed by three spine surgeons with no prior endoscopic experience; one had completed > 300 shoulder arthroscopies. Operative times were analyzed using cumulative sum (CUSUM) and linear regression. Missing data were managed using last available observation. Complications were stratified by type, phase, and surgeon. Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) for back and leg pain were assessed preoperatively and at 3 and 12 months. Results: All surgeons demonstrated a three-phase learning curve (learning, improvement, stabilization). Technical stabilization occurred after approximately 50 cases. The arthroscopy-experienced surgeon reached improvement earlier (case 12) than others (cases 24–26). Overall complication rate was 9.2%, highest during the learning phase (up to 25%). A single postoperative epidural hematoma was confirmed on MRI and resolved conservatively. ODI and VAS improved significantly at 3 and 12 months (p < 0.001), with no between-surgeon differences at final follow-up. Conclusions: Prior arthroscopic experience facilitates early adaptation to endoscopic visualization and may reduce initial neurological risk, but long-term outcomes remain comparable among surgeons. The study confirms IELD as a safe, effective technique with a reproducible ~50-case learning curve. Level of Evidence: III
Related Topics
Concepts
Medicine
Visual analogue scale
Surgery
Orthopedic surgery
Prospective cohort study
Oswestry Disability Index
Learning curve
Complication
Endoscopy
Lumbar
Cohort study
Cohort
Arthroscopy
Postoperative hematoma
Physical therapy
Patient satisfaction
Rehabilitation
Discectomy
Hematoma
Observational study
Radiology
Lumbar disc herniation
Magnetic resonance imaging
Tenotomy
Metadata
- Type
- article
- Landing Page
- https://doi.org/10.21203/rs.3.rs-8099529/v1
- https://www.researchsquare.com/article/rs-8099529/latest.pdf
- OA Status
- gold
- References
- 3
- OpenAlex ID
- https://openalex.org/W7106014066
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W7106014066Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.21203/rs.3.rs-8099529/v1Digital Object Identifier
- Title
-
Impact of Arthroscopic Experience on the Learning Curve in Interlaminar Endoscopic Lumbar Discectomy: A Single-Center Prospective Cohort Study of 240 PatientsWork title
- Type
-
articleOpenAlex work type
- Publication year
-
2025Year of publication
- Publication date
-
2025-11-19Full publication date if available
- Authors
-
Tomasz Sienkiel, Marcin Gąska, Przemysław Koszyk, Ewa Lipik, Barbara JasiewiczList of authors in order
- Landing page
-
https://doi.org/10.21203/rs.3.rs-8099529/v1Publisher landing page
- PDF URL
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https://www.researchsquare.com/article/rs-8099529/latest.pdfDirect link to full text PDF
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://www.researchsquare.com/article/rs-8099529/latest.pdfDirect OA link when available
- Concepts
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Medicine, Visual analogue scale, Surgery, Orthopedic surgery, Prospective cohort study, Oswestry Disability Index, Learning curve, Complication, Endoscopy, Lumbar, Cohort study, Cohort, Arthroscopy, Postoperative hematoma, Physical therapy, Patient satisfaction, Rehabilitation, Discectomy, Hematoma, Observational study, Radiology, Lumbar disc herniation, Magnetic resonance imaging, TenotomyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- References (count)
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3Number of works referenced by this work
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| abstract_inverted_index.MRI | 204 |
| abstract_inverted_index.ODI | 208 |
| abstract_inverted_index.The | 171, 251 |
| abstract_inverted_index.VAS | 210 |
| abstract_inverted_index.and | 25, 29, 59, 65, 74, 78, 111, 128, 134, 141, 147, 150, 205, 209, 215, 238 |
| abstract_inverted_index.but | 244 |
| abstract_inverted_index.for | 139 |
| abstract_inverted_index.had | 97 |
| abstract_inverted_index.leg | 142 |
| abstract_inverted_index.may | 239 |
| abstract_inverted_index.one | 96 |
| abstract_inverted_index.sum | 109 |
| abstract_inverted_index.the | 16, 62, 72, 190 |
| abstract_inverted_index.was | 186, 201 |
| abstract_inverted_index.≤ | 52 |
| abstract_inverted_index.> | 99 |
| abstract_inverted_index.< | 219 |
| abstract_inverted_index.(MSU | 47 |
| abstract_inverted_index.2021 | 58 |
| abstract_inverted_index.2023 | 60 |
| abstract_inverted_index.A/B, | 48 |
| abstract_inverted_index.IELD | 56, 254 |
| abstract_inverted_index.back | 140 |
| abstract_inverted_index.data | 115 |
| abstract_inverted_index.disc | 45 |
| abstract_inverted_index.last | 119 |
| abstract_inverted_index.pain | 143 |
| abstract_inverted_index.rate | 185 |
| abstract_inverted_index.than | 179 |
| abstract_inverted_index.were | 85, 105, 116, 123, 144 |
| abstract_inverted_index.with | 36, 42, 71, 91, 221, 260 |
| abstract_inverted_index.(ODI) | 133 |
| abstract_inverted_index.(VAS) | 138 |
| abstract_inverted_index.(case | 177 |
| abstract_inverted_index.25%). | 195 |
| abstract_inverted_index.9.2%, | 187 |
| abstract_inverted_index.Index | 132 |
| abstract_inverted_index.Prior | 229 |
| abstract_inverted_index.Scale | 137 |
| abstract_inverted_index.after | 167 |
| abstract_inverted_index.among | 249 |
| abstract_inverted_index.curve | 18, 160 |
| abstract_inverted_index.early | 233 |
| abstract_inverted_index.final | 226 |
| abstract_inverted_index.phase | 192 |
| abstract_inverted_index.prior | 12, 93 |
| abstract_inverted_index.rates | 28 |
| abstract_inverted_index.risk, | 243 |
| abstract_inverted_index.safe, | 257 |
| abstract_inverted_index.spine | 89 |
| abstract_inverted_index.study | 252 |
| abstract_inverted_index.three | 88 |
| abstract_inverted_index.times | 104 |
| abstract_inverted_index.type, | 126 |
| abstract_inverted_index.using | 107, 118 |
| abstract_inverted_index.(IELD) | 24 |
| abstract_inverted_index.(cases | 181 |
| abstract_inverted_index.Analog | 136 |
| abstract_inverted_index.Clinic | 75 |
| abstract_inverted_index.STROBE | 37 |
| abstract_inverted_index.Visual | 135 |
| abstract_inverted_index.cases. | 170 |
| abstract_inverted_index.cohort | 6 |
| abstract_inverted_index.curve. | 265 |
| abstract_inverted_index.during | 189 |
| abstract_inverted_index.linear | 112 |
| abstract_inverted_index.lumbar | 22, 44 |
| abstract_inverted_index.months | 217 |
| abstract_inverted_index.others | 180 |
| abstract_inverted_index.phase, | 127 |
| abstract_inverted_index.reduce | 240 |
| abstract_inverted_index.remain | 247 |
| abstract_inverted_index.single | 197 |
| abstract_inverted_index.study. | 7 |
| abstract_inverted_index.(CUSUM) | 110 |
| abstract_inverted_index.(PROs). | 32 |
| abstract_inverted_index.0.001), | 220 |
| abstract_inverted_index.Missing | 114 |
| abstract_inverted_index.Overall | 183 |
| abstract_inverted_index.between | 57 |
| abstract_inverted_index.earlier | 176 |
| abstract_inverted_index.highest | 188 |
| abstract_inverted_index.initial | 241 |
| abstract_inverted_index.managed | 117 |
| abstract_inverted_index.months) | 54 |
| abstract_inverted_index.months. | 152 |
| abstract_inverted_index.reached | 174 |
| abstract_inverted_index.surgeon | 173 |
| abstract_inverted_index.symptom | 50 |
| abstract_inverted_index.whether | 11 |
| abstract_inverted_index.Hospital | 67 |
| abstract_inverted_index.Medicum, | 81 |
| abstract_inverted_index.Oswestry | 130 |
| abstract_inverted_index.analyzed | 106 |
| abstract_inverted_index.assessed | 145 |
| abstract_inverted_index.confirms | 253 |
| abstract_inverted_index.duration | 51 |
| abstract_inverted_index.epidural | 199 |
| abstract_inverted_index.evaluate | 10 |
| abstract_inverted_index.hematoma | 200 |
| abstract_inverted_index.improved | 211 |
| abstract_inverted_index.learning | 17, 159, 191, 264 |
| abstract_inverted_index.occurred | 166 |
| abstract_inverted_index.outcomes | 31, 246 |
| abstract_inverted_index.patients | 41 |
| abstract_inverted_index.resolved | 206 |
| abstract_inverted_index.shortens | 15 |
| abstract_inverted_index.shoulder | 101 |
| abstract_inverted_index.surgeon. | 129 |
| abstract_inverted_index.surgeons | 90, 155 |
| abstract_inverted_index.~50-case | 263 |
| abstract_inverted_index.24–26). | 182 |
| abstract_inverted_index.Collegium | 80 |
| abstract_inverted_index.Operative | 103 |
| abstract_inverted_index.Technical | 164 |
| abstract_inverted_index.Zakopane, | 69 |
| abstract_inverted_index.available | 120 |
| abstract_inverted_index.completed | 98 |
| abstract_inverted_index.confirmed | 202 |
| abstract_inverted_index.effective | 258 |
| abstract_inverted_index.long-term | 245 |
| abstract_inverted_index.performed | 86 |
| abstract_inverted_index.surgeons. | 250 |
| abstract_inverted_index.technique | 259 |
| abstract_inverted_index.underwent | 55 |
| abstract_inverted_index.(learning, | 161 |
| abstract_inverted_index.Department | 73 |
| abstract_inverted_index.Disability | 131 |
| abstract_inverted_index.Orthopedic | 64 |
| abstract_inverted_index.Procedures | 84 |
| abstract_inverted_index.University | 63 |
| abstract_inverted_index.accordance | 35 |
| abstract_inverted_index.adaptation | 234 |
| abstract_inverted_index.affiliated | 70 |
| abstract_inverted_index.comparable | 248 |
| abstract_inverted_index.cumulative | 108 |
| abstract_inverted_index.discectomy | 23 |
| abstract_inverted_index.endoscopic | 21, 94, 236 |
| abstract_inverted_index.experience | 14, 231 |
| abstract_inverted_index.follow-up. | 227 |
| abstract_inverted_index.herniation | 46 |
| abstract_inverted_index.influences | 26 |
| abstract_inverted_index.stratified | 124 |
| abstract_inverted_index.<bold>Level | 266 |
| abstract_inverted_index.<bold>Study | 1 |
| abstract_inverted_index.Orthopedics | 77 |
| abstract_inverted_index.Prospective | 3 |
| abstract_inverted_index.University. | 83 |
| abstract_inverted_index.consecutive | 40 |
| abstract_inverted_index.differences | 224 |
| abstract_inverted_index.experience; | 95 |
| abstract_inverted_index.facilitates | 232 |
| abstract_inverted_index.guidelines, | 38 |
| abstract_inverted_index.improvement | 175 |
| abstract_inverted_index.regression. | 113 |
| abstract_inverted_index.three-phase | 158 |
| abstract_inverted_index.Jagiellonian | 82 |
| abstract_inverted_index.arthroscopic | 13, 230 |
| abstract_inverted_index.complication | 27, 184 |
| abstract_inverted_index.demonstrated | 156 |
| abstract_inverted_index.improvement, | 162 |
| abstract_inverted_index.interlaminar | 20 |
| abstract_inverted_index.neurological | 242 |
| abstract_inverted_index.observation. | 121 |
| abstract_inverted_index.reproducible | 262 |
| abstract_inverted_index.single-level | 43 |
| abstract_inverted_index.Complications | 122 |
| abstract_inverted_index.approximately | 168 |
| abstract_inverted_index.observational | 5 |
| abstract_inverted_index.postoperative | 198 |
| abstract_inverted_index.significantly | 212 |
| abstract_inverted_index.single-center | 4 |
| abstract_inverted_index.stabilization | 165 |
| abstract_inverted_index.visualization | 237 |
| abstract_inverted_index.Design:</bold> | 2 |
| abstract_inverted_index.Rehabilitation | 66 |
| abstract_inverted_index.arthroscopies. | 102 |
| abstract_inverted_index.non-calcified, | 49 |
| abstract_inverted_index.preoperatively | 146 |
| abstract_inverted_index.Rehabilitation, | 79 |
| abstract_inverted_index.between-surgeon | 223 |
| abstract_inverted_index.conservatively. | 207 |
| abstract_inverted_index.stabilization). | 163 |
| abstract_inverted_index.Evidence:</bold> | 268 |
| abstract_inverted_index.patient-reported | 30 |
| abstract_inverted_index.<bold>Methods:</bold> | 33 |
| abstract_inverted_index.<bold>Results:</bold> | 153 |
| abstract_inverted_index.<title>Abstract</title> | 0 |
| abstract_inverted_index.arthroscopy-experienced | 172 |
| abstract_inverted_index.<bold>Objectives:</bold> | 8 |
| abstract_inverted_index.<bold>Conclusions:</bold> | 228 |
| cited_by_percentile_year | |
| countries_distinct_count | 1 |
| institutions_distinct_count | 5 |
| citation_normalized_percentile.value | 0.82260934 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |