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| DOI | 10.21037/JSS.2019.09.32 | ||
| Año | 2020 | ||
| Tipo |
Citas Totales
Autores Afiliación Chile
Instituciones Chile
% Participación
Internacional
Autores
Afiliación Extranjera
Instituciones
Extranjeras
Background: Training of spine surgeons may impact the availability of contemporary minimally invasive spinal surgery (MIS) to patients and drive spine surgeons’ clinical decision-making when applying minimally invasive spinal surgery techniques (MISST) to the treatment of common degenerative conditions of the lumbar spine. Training requirements and implementation of privileges vary in different parts of the world. The purpose of this study was to analyze the training in relation to practice patterns of surgeons who perform lumbar endoscopic spinal surgery the world over. Methods: The authors solicited responses to an online survey sent to spine surgeons by email, and chat groups in social media networks including Facebook, WeChat, WhatsApp, and Linkedin. Surgeons were asked the following questions: (I) please indicate your training? (II) What type of MISST spinal surgery do you perform? (III) How would you rate your experience in MIS lumbar spinal surgery and what percentage of your practice is MISST? And (IV) which avenue did you use to train for the MISST you currently employ in your clinical practice today? Descriptive statistics were applied to count responses and cross-tabulated them to the surgeon’s training. Pearson Chi-square measures, kappa statistics, and linear regression analysis of agreement or disagreement were performed by analyzing the distribution of variances using statistical package SPSS version 25.0. Results: A total of 430 surgeons accessed the survey. The completion rate was 67.4%. Analyzing the responses of 292 surveys submitted by 97 neurosurgeons (33.2%), 161 orthopaedic surgeons (55.1%), and 34 surgeons of other postgraduate training (11.6%) showed that only 14% (41/292) of surgeons had completed a fellowship. Surgeons rated their skill level 33.5% of the time as master and experienced surgeon, and 35.6% of the time as novice or surgeon with some experience. There were more master (64.6% versus 29.2%) and experienced (52% versus 40%) surgeons amongst orthopaedic surgeons than amongst neurosurgeons at a statistically significant level (P=0.11). There were near twice as many orthopaedic surgeons (54.3%) using endoscopic procedures in the lumbar spine as their favorite MISST than neurosurgeons (35.4%; P=0.096). Endoscopic spine surgeons’ main sources of knowledge acquisition were (I) learning in small meetings (57.3%), (II) attending workshops (63.1%), and (III) national and international conferences (59.8%). Conclusions: The majority of spine surgeons reported more than half of their cases employing MISST at a high skill level. Very few MISST surgeons are fellowship trained but attend workshops and various meetings suggesting that many of them are self-thought. Orthopaedic surgeons were more likely to implement endoscopic spinal surgery into the routine clinical practice. As endoscopic spine surgery gains more traction and patient demand, minimal adequate training will be part of the ongoing debate.
| Ord. | Autor | Género | Institución - País |
|---|---|---|---|
| 1 | Lewandrowski, Kai-Uwe | Hombre |
Surgical Institute of Tucson - Estados Unidos
Universidade Federal do Estado do Rio de Janeiro - Brasil |
| 2 | Correa, Cristian | Hombre |
American British Cowdray Medical Center - México
Reina Sofía Clinic & Center of Minimally Invasive Spine Surgery - Colombia Universidad Sanitas - Colombia CLINCOL (Endoscopic Spine Clinic) - Brasil Isar Medizin Zentrum - Alemania Endoscopic Spine Clinic - Chile Universidade de Sao Paulo - USP - Brasil Hanyang University Guri Hospital - Corea del Sur Sushruta Hospital for Orthopaedics & Traumatology - India UNM School of Medicine - Estados Unidos Desert Institute for Spine Care - Estados Unidos Universidade de São Paulo - Brasil |
| 3 | Zhang, Xifeng | - |
General Hospital of People's Liberation Army - China
|
| 4 | Correa, Cristian | Hombre |
American British Cowdray Medical Center - México
Reina Sofía Clinic & Center of Minimally Invasive Spine Surgery - Colombia Universidad Sanitas - Colombia CLINCOL (Endoscopic Spine Clinic) - Brasil Isar Medizin Zentrum - Alemania Endoscopic Spine Clinic - Chile Universidade de Sao Paulo - USP - Brasil Hanyang University Guri Hospital - Corea del Sur Sushruta Hospital for Orthopaedics & Traumatology - India UNM School of Medicine - Estados Unidos Desert Institute for Spine Care - Estados Unidos Universidade de São Paulo - Brasil |
| 5 | Soriano Solis, Sergio | Hombre |
American British Cowdray Medical Center - México
|
| 6 | Rugeles-Ortíz, José Gabriel | Hombre |
Universidad Sanitas - Colombia
|
| 7 | Alonso Cuéllar, Gabriel Oswaldo | Hombre |
Minimally Invasive and Bariatric Surgery - Colombia
Center of Minimally Invasive Spine Surgery - Colombia |
| 8 | Correa, Cristian | Hombre |
American British Cowdray Medical Center - México
Reina Sofía Clinic & Center of Minimally Invasive Spine Surgery - Colombia Universidad Sanitas - Colombia CLINCOL (Endoscopic Spine Clinic) - Brasil Isar Medizin Zentrum - Alemania Endoscopic Spine Clinic - Chile Universidade de Sao Paulo - USP - Brasil Hanyang University Guri Hospital - Corea del Sur Sushruta Hospital for Orthopaedics & Traumatology - India UNM School of Medicine - Estados Unidos Desert Institute for Spine Care - Estados Unidos Universidade de São Paulo - Brasil |
| 9 | Correa, Cristian | Hombre |
American British Cowdray Medical Center - México
Reina Sofía Clinic & Center of Minimally Invasive Spine Surgery - Colombia Universidad Sanitas - Colombia CLINCOL (Endoscopic Spine Clinic) - Brasil Isar Medizin Zentrum - Alemania Endoscopic Spine Clinic - Chile Universidade de Sao Paulo - USP - Brasil Hanyang University Guri Hospital - Corea del Sur Sushruta Hospital for Orthopaedics & Traumatology - India UNM School of Medicine - Estados Unidos Desert Institute for Spine Care - Estados Unidos Universidade de São Paulo - Brasil |
| 10 | Correa, Cristian | Hombre |
American British Cowdray Medical Center - México
Reina Sofía Clinic & Center of Minimally Invasive Spine Surgery - Colombia Universidad Sanitas - Colombia CLINCOL (Endoscopic Spine Clinic) - Brasil Isar Medizin Zentrum - Alemania Endoscopic Spine Clinic - Chile Universidade de Sao Paulo - USP - Brasil Hanyang University Guri Hospital - Corea del Sur Sushruta Hospital for Orthopaedics & Traumatology - India UNM School of Medicine - Estados Unidos Desert Institute for Spine Care - Estados Unidos Universidade de São Paulo - Brasil |
| 11 | Prada, Nicholas | Hombre |
FOSCAL International Clinic - Colombia
|
| 12 | Correa, Cristian | Hombre |
American British Cowdray Medical Center - México
Reina Sofía Clinic & Center of Minimally Invasive Spine Surgery - Colombia Universidad Sanitas - Colombia CLINCOL (Endoscopic Spine Clinic) - Brasil Isar Medizin Zentrum - Alemania Endoscopic Spine Clinic - Chile Universidade de Sao Paulo - USP - Brasil Hanyang University Guri Hospital - Corea del Sur Sushruta Hospital for Orthopaedics & Traumatology - India UNM School of Medicine - Estados Unidos Desert Institute for Spine Care - Estados Unidos Universidade de São Paulo - Brasil |
| 13 | Correa, Cristian | Hombre |
American British Cowdray Medical Center - México
Reina Sofía Clinic & Center of Minimally Invasive Spine Surgery - Colombia Universidad Sanitas - Colombia CLINCOL (Endoscopic Spine Clinic) - Brasil Isar Medizin Zentrum - Alemania Endoscopic Spine Clinic - Chile Universidade de Sao Paulo - USP - Brasil Hanyang University Guri Hospital - Corea del Sur Sushruta Hospital for Orthopaedics & Traumatology - India UNM School of Medicine - Estados Unidos Desert Institute for Spine Care - Estados Unidos Universidade de São Paulo - Brasil |
| 14 | Correa, Cristian | Hombre |
American British Cowdray Medical Center - México
Reina Sofía Clinic & Center of Minimally Invasive Spine Surgery - Colombia Universidad Sanitas - Colombia CLINCOL (Endoscopic Spine Clinic) - Brasil Isar Medizin Zentrum - Alemania Endoscopic Spine Clinic - Chile Universidade de Sao Paulo - USP - Brasil Hanyang University Guri Hospital - Corea del Sur Sushruta Hospital for Orthopaedics & Traumatology - India UNM School of Medicine - Estados Unidos Desert Institute for Spine Care - Estados Unidos Universidade de São Paulo - Brasil |