Development of a Curriculum for Minimally Invasive Spine Surgery (MISS)

Schmidt, Franziska Anna; Wong, Taylor; Kırnaz, Sertaç; Taboada, Néstor; Assaker, Richard; Hofstetter, Christoph P.; Kim, Jin-Sung; Parajón, A.; Taylor, Paul; Assous, Muhammed; Härtl, Roger

doi:10.1177/2192568220910711

Cited by 11 publications

(6 citation statements)

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“…It is associated with a high cost for implementation in most countries, as well as a steep learning curve that involves understanding anatomical landmarks through narrow surgical ports and limited visualization of the surgical cavity, all without tactile sensation. 13 14 It is difficult to precisely estimate the learning curve for MISS, as there is a high variability between different types of procedures: whereas previous reports indicated a minimum of 39 cases to become 90% proficient in MISS TLIF, other reports indicated 72 as the minimum to become 90% proficient in MISS lumbar discectomy. 15 16 17 With this complex learning curve, it is therefore essential for the community to develop standard educational programs to minimize learning curve-induced complications.…”

Section: Discussionmentioning

confidence: 99%

Educational Status of Minimally Invasive Spine Surgery

Pereira,

Garg,

Mamaril-Davis

et al. 2023

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Background The objective of this study was to understand how spine surgeons learn minimally invasive spine surgery (MISS) and how the COVID-19 pandemic impacted the educational experience of MISS. Potential solutions for increasing the spine surgeon's access to MISS educational resources were also discussed. Methods An internet survey was distributed to neurosurgical and orthopedic spine surgeons across multiple online platforms from April to June 2021, asking specific questions about education and training for MISS. Online survey tools were used to contact spine surgeons in the five geographical continents. Results A total of 303 spine surgeons responded to the survey: 272 (89.7%) neurosurgeons and 31 (10.3%) orthopedic surgeons. The six countries with the greatest number of participants were: Argentina (n = 70; 23.1%), India (n = 47; 15.5%), Brazil (n = 34; 11.2%), Pakistan (n = 10; 3.3%), Mexico (n = 9; 3.0%), and Chile (n = 8; 2.6%). Conclusion Most spine surgeons were able to attend virtual learning events during the pandemic, but cadaveric study was still considered the gold standard for learning MISS. Multidisciplinary effort is needed to develop structured curriculums for teaching MISS that include a variety of educational tools such as cadaver laboratory, guidance from experienced surgeons, and virtual demonstrations.

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Section: Discussionmentioning

confidence: 99%

Educational Status of Minimally Invasive Spine Surgery

Pereira,

Garg,

Mamaril-Davis

et al. 2023

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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“…Minimally Invasive spine surgery is aptly defined by AOSpine MISS Curriculum Task Force [12]. They defined as "Minimally invasive spine surgery (MISS) is a suite of technology-dependent techniques and procedures that reduces local operative tissue damage and systemic surgical stress enabling earlier return to function striving for better outcomes than traditional techniques".…”

Section: Scope Of Minimally Invasive Spine Surgery In Routine Spine Practicementioning

confidence: 99%

Incorporation of MISS in Routine Spine Practice

2021

BBJ

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Traditional open spine surgery is the gold standard procedure in spine practice. Minimally invasive spine surgery (MISS) since last two decades have tremendously improved in technique and technology improving the clinical and functional outcomes of the surgery and patients. But still MISS has steep learning curve, many challenges and hurdles to inculcate it in the routine spine practice of the surgeon who may be either a novice or even an established in spine practice. The author has tried to identify the hurdles in incorporating MISS in routine spine practice and suggested methods to overcome these hurdles to incorporate MISS in routine clinical practice. Keywords: Minimally Invasive Spine Surgery (MISS); Spine practice; Spine Surgeon.

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“…In minimally invasive tubular surgery, dural tears may occur when the yellow ligament is removed [13,14]. A curriculum roadmap in MISS has also been outlined previously: Brie y, standardized technique protocols and outcome metrics are required to deliver effective training and education in MISS [15]. The critical steps in unilateral laminotomy for bilateral decompression using a tubular approach have been agreed upon by a panel of 29 surgical experts.…”

Section: Introductionmentioning

confidence: 99%

Ten-Step Minimally Invasive Slalom Unilateral Laminotomy for Bilateral Decompression (sULBD) with Navigation

Adelhoefer

Berger

Mykolajtchuk

et al. 2023

Preprint

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Background Unilateral laminotomy for bilateral decompression (ULBD) is a MIS surgical technique that offers safe and effective decompression of lumbar spinal stenosis (LSS) with a long-term resolution of symptoms. Advantages over conventional open laminectomy include reduced expected blood loss, muscle damage, mechanical instability, and less postoperative pain. The slalom technique combined with navigation is used in multi-segmental LSS to improve the workflow and effectiveness of the procedure. Methods We outline ten technical steps to achieve a slalom unilateral laminotomy for bilateral decompression (sULBD) with navigation. In a retrospective case series, we included patients with multi-segmental LSS operated in our institution using the sULBD between 2020-2022. The primary outcome was a reduction in pain measured by Visual Analogue Scale (VAS) for back pain and leg pain and Oswestry Disability Index (ODI). Results In our case series (N=7), all patients reported resolution of initial symptoms on an average follow-up of 20.71 ± 9 months. The average operative time and length of hospital stay were 196.14 minutes and 1.67 days, respectively. On average, VAS (back pain) was 4.71 pre-operatively and 1.50 on long-term follow-up of an average of 19.05 months. VAS (leg pain) decreased from 4.33 to 1.21. ODI was reported as 33 % pre-operatively and 12 % on long-term follow-up. Conclusion The sULBD with navigation is a safe and effective MIS surgical procedure and achieves the resolution of symptoms in patients presenting with multi-segmental LSS. Herein, we demonstrate the ten key steps required to perform the sULBD technique. Compared to the standard sULBD technique, the incorporation of navigation provides anatomic localization without exposure to radiation to staff for a higher safety profile along with a fast and efficient workflow.

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Development of a Curriculum for Minimally Invasive Spine Surgery (MISS)

Cited by 11 publications

References 0 publications

Educational Status of Minimally Invasive Spine Surgery

Educational Status of Minimally Invasive Spine Surgery

Incorporation of MISS in Routine Spine Practice

Ten-Step Minimally Invasive Slalom Unilateral Laminotomy for Bilateral Decompression (sULBD) with Navigation

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