Mastering Minimally Invasive Spine Surgery: Analyzing the Learning Curve, Safety Insights, and Complication Rates in Modern Spinal Procedures

Abstract

Background: Minimally invasive spine surgery (MISS) is a technique that minimizes tissue trauma and has a quicker recovery period, but it can be quite technically demanding. Operative efficiency and patient safety could be affected by the learning curve.

Objective: To assess the learning curve, perioperative outcomes, and complication rates of MISS.

Methods: A retrospective analytical cohort study with 154 consecutive adult patients who underwent MISS in a tertiary-care hospital was performed. Demographic, clinical, operative, and postoperative data were obtained. Patients were divided into groups based on the number of years they had performed the surgery. Assessed were duration of operation, blood loss, hospitalization, conversion to open surgery, and complications. The proficiency threshold was determined by using a CUSUM analysis, and logistic regression was performed to determine factors associated with complications.

Results: Mean age was 48.6 ± 11.7 years, and 59.1% were male. Operative duration decreased from 123.4 ± 39.6 to 86.7 ± 27.8 minutes, while blood loss decreased from 112.6 ± 64.1 to 69.5 ± 41.7 mL between early and proficiency phases (both p<0.001). Complications decreased from 18.2% to 6.5% (p=0.028). The proficiency was detected using CUSUM analysis at about 66-70 cases. Complications were independently associated with early case surgery (p=0.014).

Conclusion: MISS showed a significant learning curve, showing progressive improvements in working efficiently and safely as the experience increased.