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. 2020 Jan;6(Suppl 1):S224-S236.
doi: 10.21037/jss.2019.12.13.

Is Asia truly a hotspot of contemporary minimally invasive and endoscopic spinal surgery?

Jin-Sung Kim  1 , Anthony Yeung  2   3 , Yadhu K Lokanath  1 , Kai-Uwe Lewandrowski  4
Affiliations

Is Asia truly a hotspot of contemporary minimally invasive and endoscopic spinal surgery?

Jin-Sung Kim et al. J Spine Surg. 2020 Jan.

Abstract

Background: The purpose of this study was to analyze the training in relation to practice patterns of surgeons in Asia who perform lumbar endoscopic spinal surgery in comparison to surgeons the world over. The authors solicited responses to an online survey sent to spine surgeons.

Methods: Pearson Chi-Square measures, Kappa statistics, and linear regression analysis of agreement or disagreement were performed by analyzing the distribution of variances of responses in relation to surgeons' training using statistical package SPSS Version 25.0.

Results: A total of 430 surgeons accessed the survey. The completion rate was 67.4%. Analyzing the responses of 292 surveys submitted by 97 neurosurgeons (33.2%), 161 orthopaedic surgeons (55.1%), and 34 surgeons of other postgraduate training (11.6%) showed that only 14.0% (41/292) of surgeons had completed a fellowship. Ninety-one of the 292 respondents were from Asian countries/regions. A statistically significantly higher percentage of Asian surgeons (96.7%) compared to non-Asian surgeons (81.6%) indicated that they perform modern minimally invasive (MIS) and endoscopic spinal (ES) surgery (P=0.001). Spinal endoscopy was employed by 70.3% of Asian versus 55.2% of non-Asian surgeons (P=0.015). Endoscopic decompression techniques requiring advanced training was employed nearly twice as high by the Asian surgeons than by non-Asian.

Conclusions: Training requirements for MIS and ES surgery and implementation of privileges vary in different parts of the world. While industry-sponsored weekend cadaver workshops have remained the mainstay of training aspiring endoscopic spinal surgeons in North America and Europe leaving many of them to become autodidacts.

Keywords: Lumbar minimally invasive spinal surgery; endoscopy; herniated disc; spinal stenosis.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Representative questions of the spine surgeon opinion survey inquiring about postgraduate residency training, types of preferred MIS, experience and percentage of clinical practice devoted to MIS. MIS, minimally invasive surgery.
Figure 2
Figure 2
Age distribution surgeons from Asia versus other countries/regions
Figure 3
Figure 3
Do you perform MIS or ES Surgery? MIS, modern minimally invasive; ES, endoscopic spinal.
Figure 4
Figure 4
Tubular retractor use Asian versus other countries/regions. MIS, modern minimally invasive.
Figure 5
Figure 5
Endoscopic surgery implementation Asia versus other countries/regions. MIS, modern minimally invasive.
See this image and copyright information in PMC

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