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The learning curve of lateral access lumbar interbody fusion in an Asian population: a prospective study

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Abstract

Purpose

Lateral access lumbar interbody fusion (LLIF) is a minimally invasive technique that has an increasing popularity. It offers unique advantages and circumvents risk of certain serious complications encountered in other conventional spinal approaches. This study provides a statistical analysis defining the lateral access learning curve in the Asian population.

Methods

This prospective study included 32 consecutive patients who underwent LLIF from April 2012 to August 2014. The surgeries were performed by two senior spine surgeons and follow-up was conducted at 6 weeks, 3, 6, 9 months and 1 year post-operation.

Results

The breakpoint in operating time occurred at the 22nd level operated, from a mean of 71 min in the early phase group to a mean of 42 min in the steady state group. LLIF at L4/5 level is technically more demanding but technically feasible as competency is achieved.

Conclusions

During the learning process, there was no compromise of perioperative or clinical outcomes. It should be feasibly incorporated into a spine surgeon’s repertoire of procedures for the lumbar spine.

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Acknowledgments

We would like to acknowledge Richard Tjahjono, medical illustrator, for his drawings used in this article.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Spine Surgery, Deptartment of Orthopedics, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore, 308433, Singapore

    Chong Leslie Lich Ng & Selvaraj Dahshaini

  2. National Neuroscience Institute, Jalan Tan Tock Seng, Singapore, 308433, Singapore

    Boon Chuan Pang

  3. Department of Orthopedics, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore, 308433, Singapore

    Paul Julius A. Medina

  4. Faculty of Medicine, UNSW Medicine, University of New South Wales, UNSW, Sydney, 2052, Australia

    Kimberly-Anne Tan

  5. Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore, 308433, Singapore

    Li-Zhen Liu

Authors
  1. Chong Leslie Lich Ng
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  2. Boon Chuan Pang
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  3. Paul Julius A. Medina
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  4. Kimberly-Anne Tan
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  5. Selvaraj Dahshaini
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  6. Li-Zhen Liu
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Correspondence to Chong Leslie Lich Ng.

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Ng, C.L.L., Pang, B.C., Medina, P.J.A. et al. The learning curve of lateral access lumbar interbody fusion in an Asian population: a prospective study. Eur Spine J 24 (Suppl 3), 361–368 (2015). https://doi.org/10.1007/s00586-015-3876-3

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  • DOI: https://doi.org/10.1007/s00586-015-3876-3

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