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59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

01. - 04.06.2008, Würzburg

Complication rate of lumbar disc microsurgery depending on the surgeon's level of training

Klinische Ergebnisse bei mikrochirurgischen lumbalen Bandscheibeneingriffen in Abhängigkeit des neurochirurgischen Ausbildungsstands

Meeting Abstract

  • corresponding author I. Pechlivanis - Neurochirurgische Klinik, Ruhr Universität Bochum, Knappschaftskrankenhaus Bochum-Langendreer, Deutschland
  • M. Engelhardt - Neurochirurgische Klinik, Ruhr Universität Bochum, Knappschaftskrankenhaus Bochum-Langendreer, Deutschland
  • M. Scholz - Neurochirurgische Klinik, Ruhr Universität Bochum, Knappschaftskrankenhaus Bochum-Langendreer, Deutschland
  • A. Harders - Neurochirurgische Klinik, Ruhr Universität Bochum, Knappschaftskrankenhaus Bochum-Langendreer, Deutschland
  • K. Schmieder - Neurochirurgische Klinik, Ruhr Universität Bochum, Knappschaftskrankenhaus Bochum-Langendreer, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMI.07.08

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2008/08dgnc250.shtml

Veröffentlicht: 30. Mai 2008

© 2008 Pechlivanis et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Lumbar disc surgery is one of the operations performed early in neurosurgical training. Agreement exists concerning the use of microsurgical techniques. With increasing surgical experience, the clinical outcome should be better, partly based on a reduced complication rate. The aim of this study was to evaluate the patients’ immediate clinical outcome and perioperative complication rate correlated to the surgeon's level of experience.

Methods: In this study, patients with surgery for lumbar disc herniation between 1998–2000 were analysed. Exclusion criteria were recurrent disc herniations and spinal stenosis. The surgeons were divided into 4 groups depending on the surgical experience (group A: ≤2 yrs., group B: 3–6 yrs., group C: 7–10 yrs., group D: >10 yrs.). Analysis was done in regard to anthropometric data, duration of the surgery, early- and late surgery-related complications and outcome at discharge.

Results: 1205 patients (556 patients females, 649 males) were entered. The mean age at operation was 49 yrs. Mean body-mass-Index was 25.8. 606 out of the 1205 patients were treated by surgeons ≤6 years of training. In 75 patients (6.2%) re-operation was necessary due to early re-herniation. The rate was lowest (0.5%) in group A and similar (1.7%–2.1%) in the other groups. Intraoperative complication rate was highest (1.6%) in group B. Although the duration of surgery in group A was longer (103 min) compared to the other groups, the rate of intraoperative complications was significantly lower (0.3%). Furthermore, in this group, fewer patients had persistant postoperative radicular pain.

Conclusions: The quality of clinical outcome after surgery for lumbar disc herniation does not increase in a linear arithmetic fashion with the surgeon's experience. As expected, intraoperative complication rate is highest between the 3rd and the 6th year of training.