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ORIGINAL RESEARCH article

Front. Surg.
Sec. Neurosurgery
Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1405519

Unilateral Biportal Endoscopic Spine Surgery: A Meta-Analysis Unveiling the Learning Curve and Clinical Benefits

Provisionally accepted
Shu-Xin Liu Shu-Xin Liu 1Li-Ru He Li-Ru He 2Chien-Min Chen Chien-Min Chen 3Shang-Wun Jhang Shang-Wun Jhang 3Guang-Xun Lin Guang-Xun Lin 2*
  • 1 Panjin Central Hospital, Panjin, China
  • 2 First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, China
  • 3 Changhua Christian Hospital, Changhua, Taiwan

The final, formatted version of the article will be published soon.

    Objective: To provide insights into the learning curve of unilateral biportal endoscopic (UBE) spine surgery by synthesizing available evidence on critical points and associated clinical outcomes. Methods: A comprehensive literature search was conducted across multiple databases, yielding a pool of relevant studies. Inclusion criteria encompassed studies reporting on UBE learning curves and quantitative data related to clinical outcomes (operative time, hospital stay, and complications). Results: A total of five studies were included in the analysis, providing six datasets to elucidate the UBE learning curve. Three of the five studies analyzed learning curves using the Cumulative Sum method and identified cutoff points. One study plotted learning curves and determined cutoff points based on surgical time analysis, while the remaining one study (providing two datasets) plotted learning curves using the phased analysis method. The mean value of the cutoff point in terms of the number of cases required to reach proficiency in time to surgery was calculated at 37.5 cases, with a range spanning from 14 to 58 cases. Notably, there was a statistically significant difference in time to surgery between the late group and the early group, with the late group demonstrating a significantly reduced time to surgery (P < 0.0001). Additionally, the determined cutoff points exhibited significant variations when applied to patient outcome parameters, including postoperative hospitalization, postoperative drainage, and surgical complications (P < 0.05). Conclusion: While the analysis indicates that UBE surgery's learning curve is associated with surgical time, the limited focus on this metric and potential discrepancies in cutoff point determination highlight the need for a more comprehensive understanding.

    Keywords: Unilateral biportal endoscopic, UBE, BESS, Lumbar degenerative disease, Learning Curve

    Received: 18 Jun 2024; Accepted: 15 Oct 2024.

    Copyright: © 2024 Liu, He, Chen, Jhang and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Guang-Xun Lin, First Affiliated Hospital of Xiamen University, Xiamen, 361001, Fujian Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.