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 |