Metrics Development for Minimal Invasive Unilateral Laminotomy for Bilateral Decompression of Lumbar Spinal Stenosis With and Without Spondylolisthesis by an International Expert Panel.

Publication Type	Academic Article
Authors	Melcher C, Korge A, Cunningham M, Foley K, Härtl R
Journal	Global Spine J
Volume	10
Issue	2 Suppl
Pagination	168S-175S
Date Published	05/28/2020
ISSN	2192-5682
Abstract	STUDY DESIGN: Prospective study. OBJECTIVES: To develop, operationally define, and seek consensus from procedure experts on the metrics that best characterize a reference approach to the performance of a minimally invasive unilateral laminotomy for bilateral decompression (ULBD) for lumbar spinal stenosis. METHODS: A Metrics Group consisting of 3 experienced spine surgeons (2 neurosurgeons, 1 orthopedic surgeon), each with over 25 years of clinical practice, and an educational expert formed the Metrics Group that characterized a lumbar decompression surgery for spinal stenosis as a "reference" procedure. In a modified Delphi panel, 26 spine surgeons from 14 countries critiqued these metrics and their operational definitions before reaching consensus. RESULTS: Performance metrics consisting of 6 phases with 42 steps, 21 errors, and 17 sentinel errors were identified that characterize the procedure. During the peer review, these were evaluated, modified, and agreed. CONCLUSIONS: Surgical procedures can be broken down into elemental tasks necessary for the safe and effective completion of a reference approach to a specified surgical procedure. Spinal experts from 16 countries reached consensus on performance metrics for the procedure. This metric-based characterization can be used in a training curriculum and also for assessment of training and performance in clinical practice.
DOI	10.1177/2192568219893675
PubMed ID	32528801
PubMed Central ID	PMC7263325