Kai-Uwe Lewandrowski1,2, José-Antonio Soriano-Sánchez3, Xifeng Zhang4, Jorge Felipe Ramírez León5,6,7, Sergio Soriano Solis8, José Gabriel Rugeles Ortíz6,7, Carolina Ramírez Martínez6,7, Gabriel Oswaldo Alonso Cuéllar9, Kaixuan Liu10, Qiang Fu11, Marlon Sudário de Lima E Silva12,13, Paulo Sérgio Teixeira de Carvalho14, Stefan Hellinger15, Álvaro Dowling16,17, Nicholas Prada18, Gun Choi19, Girish Datar20, Anthony Yeung21,22. 1. Center for Advanced Spine Care of Southern Arizona and Surgical Institute of Tucson, Tucson, AZ 85712, USA. 2. Department Neurosurgery, UNIRIO, Rio de Janeiro, Brazil. 3. Neurological Center, ABC Medical Center, Mexico City, Mexico. 4. Orthopaedic Surgeon, The Chinese PLA General Hospital, Beijing 100000, China. 5. Orthopedic & Minimally Invasive Spine Surgeon, Reina Sofía Clinic & Center of Minimally Invasive Spine Surgery, Bogotá, Colombia. 6. Spine Surgery Program, Universidad Sanitas, Bogotá, Colombia. 7. Shareholder & President of Board of Directors Ortomac, Colombia, Consultant Elliquence, USA. 8. ABC Medical Center, Campus Santa Fe, Mexico City, Mexico. 9. Center of Minimally Invasive Spine Surgery, Bogotá, Colombia. 10. Atlantic Spine Center, West Orange, NJ, USA. 11. Department of Orthopedics, Shanghai General Hospital, Shanghai 200000, China. 12. Director of CLINCOL (Endoscopic Spine Clinic), Belo Horizonte, Minas Gerais, Brazil. 13. ENDOCOLUNA Member, CAECC, Brazil. 14. Department of Neurosurgery, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. 15. Orthopaedic Surgeon, 80333 München, Germany. 16. Orthopaedic Spine Surgeon, Endoscopic Spine Clinic, Santiago, Chile. 17. Department of Orthopaedic Surgery, USP, Ribeirão Preto, Brazil. 18. Orthopaedic Spine Surgeon, Foscal International Clinic, Consultant Elliquence, USA. 19. Orthopaedic Surgeon, Gun Hospital, Pohang, Korea. 20. Orthopaedic Surgeon, Center for Endoscopic Spine Surgery, Sushruta Hospital for Orthopaedics & Traumatology, Miraj, Sangli, Maharashtra, India. 21. University of New Mexico School of Medicine, Albuquerque, New Mexico, USA. 22. Desert Institute for Spine Care, Phoenix, AZ, USA.
Abstract
BACKGROUND: Regional differences in acceptance and utilization of MISST by spine surgeons may have an impact on clinical decision-making and the surgical treatment of common degenerative conditions of the lumbar spine. The purpose of this study was to analyze the acceptance and utilization of various minimally invasive spinal surgery techniques (MISST) by spinal surgeons the world over. METHODS: The authors solicited responses to an online survey sent to spine surgeons by email, and chat groups in social media networks including Facebook, WeChat, WhatsApp, and Linkedin. Surgeons were asked the following questions: (I) Do you think minimally invasive spinal surgery is considered mainstream in your area and practice setting? (II) Do you perform minimally invasive spinal surgery? (III) What type of MIS spinal surgery do you perform? (IV) If you are performing endoscopic spinal decompression surgeries, which approach do you prefer? The responses were cross-tabulated by surgeons' demographic data, and their practice area using the following five global regions: Africa & Middle East, Asia, Europe, North America, and South America. Pearson Chi-Square measures, Kappa statistics, and linear regression analysis of agreement or disagreement were performed by analyzing the distribution of variances using statistical package SPSS Version 25.0. RESULTS: A total of 586 surgeons accessed the survey. Analyzing the responses of 292 submitted surveys regional differences in opinion amongst spine surgeons showed that the highest percentage of surgeons in Asia (72.8%) and South America (70.2%) thought that MISST was accepted into mainstream spinal surgery in their practice area (P=0.04) versus North America (62.8%), Europe (52.8%), and Africa & Middle East region (50%). The percentage of spine surgeons employing MISST was much higher per region than the rate of surgeons who thought it was mainstream: Asia (96.7%), Europe (88.9%), South America (88.9%), and Africa & Middle East (87.5%). Surgeons in North America reported the lowest rate of MISST implementation globally (P<0.000). Spinal endoscopy (59.9%) is currently the most commonly employed MISST globally followed by mini-open approaches (55.1%), and tubular retractor systems (41.8%). The most preferred endoscopic approach to the spine is the transforaminal technique (56.2%) followed by interlaminar (41.8%), full endoscopic (35.3%), and over the top MISST (13.7%). CONCLUSIONS: The rate of implementation of MISST into day-to-day clinical practice reported by spine surgeons was universally higher than the perceived acceptance rates of MISST into the mainstream by their peers in their practice area. The survey suggests that endoscopic spinal surgery is now the most commonly performed MISST. 2020 Journal of Spine Surgery. All rights reserved.
BACKGROUND: Regional differences in acceptance and utilization of MISST by spine surgeons may have an impact on clinical decision-making and the surgical treatment of common degenerative conditions of the lumbar spine. The purpose of this study was to analyze the acceptance and utilization of various minimally invasive spinal surgery techniques (MISST) by spinal surgeons the world over. METHODS: The authors solicited responses to an online survey sent to spine surgeons by email, and chat groups in social media networks including Facebook, WeChat, WhatsApp, and Linkedin. Surgeons were asked the following questions: (I) Do you think minimally invasive spinal surgery is considered mainstream in your area and practice setting? (II) Do you perform minimally invasive spinal surgery? (III) What type of MIS spinal surgery do you perform? (IV) If you are performing endoscopic spinal decompression surgeries, which approach do you prefer? The responses were cross-tabulated by surgeons' demographic data, and their practice area using the following five global regions: Africa & Middle East, Asia, Europe, North America, and South America. Pearson Chi-Square measures, Kappa statistics, and linear regression analysis of agreement or disagreement were performed by analyzing the distribution of variances using statistical package SPSS Version 25.0. RESULTS: A total of 586 surgeons accessed the survey. Analyzing the responses of 292 submitted surveys regional differences in opinion amongst spine surgeons showed that the highest percentage of surgeons in Asia (72.8%) and South America (70.2%) thought that MISST was accepted into mainstream spinal surgery in their practice area (P=0.04) versus North America (62.8%), Europe (52.8%), and Africa & Middle East region (50%). The percentage of spine surgeons employing MISST was much higher per region than the rate of surgeons who thought it was mainstream: Asia (96.7%), Europe (88.9%), South America (88.9%), and Africa & Middle East (87.5%). Surgeons in North America reported the lowest rate of MISST implementation globally (P<0.000). Spinal endoscopy (59.9%) is currently the most commonly employed MISST globally followed by mini-open approaches (55.1%), and tubular retractor systems (41.8%). The most preferred endoscopic approach to the spine is the transforaminal technique (56.2%) followed by interlaminar (41.8%), full endoscopic (35.3%), and over the top MISST (13.7%). CONCLUSIONS: The rate of implementation of MISST into day-to-day clinical practice reported by spine surgeons was universally higher than the perceived acceptance rates of MISST into the mainstream by their peers in their practice area. The survey suggests that endoscopic spinal surgery is now the most commonly performed MISST. 2020 Journal of Spine Surgery. All rights reserved.
Authors: Carol A Mancuso; Roland Duculan; Frank P Cammisa; Andrew A Sama; Alexander P Hughes; Darren R Lebl; Federico P Girardi Journal: Spine J Date: 2016-04-18 Impact factor: 4.166
Authors: Kai-Uwe Lewandrowski; Friedrich Tieber; Stefan Hellinger; Paulo Sérgio Teixeira de Carvalho; Max Rogério Freitas Ramos; Zhang Xifeng; André Luiz Calderaro; Thiago Soares Dos Santos; Jorge Felipe Ramírez León; Marlon Sudário de Lima E Silva; Girish Datar; Jin-Sung Kim; Hyeun Sung Kim; Anthony Yeung Journal: Int J Spine Surg Date: 2021-12
Authors: Kai-Uwe Lewandrowski; Albert E Telfeian; Stefan Hellinger; Max R F Ramos; Hyeun Sung Kim; Daniel W Hanson; Nimar Salari; Anthony Yeung Journal: Int J Spine Surg Date: 2021-12