UBE TLIF, Inverted Learning Curve. Our Experience in an Iberic Hospital

Resumo

A técnica cirúrgica evoluiu continuamente, desde a cirurgia aberta até métodos minimamente invasivos. Os cirurgiões de coluna estão sempre buscando as melhores soluções, buscando aumentar a satisfação do paciente. O conceito e o objetivo da cirurgia minimamente invasiva são diminuir a destruição de músculos e estruturas ósseas, reduzindo assim a dor e encurtando o tempo de recuperação dos pacientes operados. Relatamos nossa primeira experiência com TLIF por UBE com cages comuns e com cages grandes para OLIF. Todos os colegas e a literatura recomendam adquirir alguma experiência inicial realizando descompressões pela técnica UBE e, após ganhar confiança, começar a realizar TLIF por UBE, sendo a curva de aprendizado descrita como íngreme. Quebramos esse conceito e começamos a realizar TLIF sem qualquer experiência na realização de descompressão por UBE. Nossa equipe é composta por um neurocirurgião e cirurgiões ortopédicos, e o fator facilitador foi a experiência prévia com endoscopia uniportal, e os cirurgiões ortopédicos eram habilidosos em triangulação, pois realizavam cirurgias artroscópicas do joelho. Não recomendamos esse tipo de curva de aprendizado; apenas queremos compartilhar nossa experiência.

Palavras-chave

Biportal; Endoscopia; Decscompressão

Abstract

The surgical technique has developed continuously from open surgery to minimally invasive methods, the spine surgeons always are looking for better solutions, trying to improve patient‘s satisfaction. The concept and goal of minimally invasive surgery is to diminish the destruction of muscles and bony structures, thus reducing the pain and shortening the recuperation of the operated patients. We report our first experience with UBE TLIF with normal used cages and with large cages used for OLIF. All colleagues and the literature recommend to gain some initial experience by doing decompressions by UBE technique and after gaining confidence to start doing UBE TLIF, the learning curve being described as steep. We broke this concept and started to do TLIF without any experience in performing UBE decompression. Our team is composed by a neurosurgeon and orthopedic surgeons and the facilitating factor was some anterior experience with uniportal endoscopy and the orthopedic surgeons were skilled in triangulation because was preforming arthroscopic knee surgeries. We do not advise this type of learning curve; we just want to count our experience.

Keywords

Biportal; Endoscopy; Decompression

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