RT Journal Article
SR Electronic
T1 Insights on High-Value Procedures From the ISASS 4-Part Webinar Series on Current and Emerging Techniques in Endoscopic Spine Surgery Based on Surgeon Experience
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP S66
OP S82
DO 10.14444/8676
VO 18
IS S2
A1 Lewandrowski, Kai-Uwe
A1 Li, Zhen-Zhou
A1 Liu, Xinyu
A1 Xifeng, Zhang
A1 Kwon, Brian
A1 Dowling, Álvaro
A1 Knight, Martin
A1 Terxeira de Carvalho, Paulo Sergio
A1 Kim, Choll
A1 Basil, Gregory W.
A1 Alonso Cuéllar, Gabriel Oswaldo
A1 Morgenstern, Christian
A1 Ongulade, John
A1 Jiang, Yi
A1 Ito, Kenyu
A1 Bergamaschi, João Paulo
A1 Kim, Jin-Sung L.
A1 Ramirez, Jorge F.
A1 Oertel, Joachim
A1 Elfar, John C.
A1 Alhammoud, Abduljabbar
A1 Bonazza, Nicholas A.
A1 Burkhardt, Benedikt W.
A1 Alvim Fiorelli, Rossano Kepler
A1 Schmidt, Sergio Luis
A1 Lorio, Morgan P.
YR 2024
UL https://www.ijssurgery.com/content/18/S2/S66.abstract
AB Background The authors conducted a comprehensive review and integration of insights from 4 webinars hosted by the International Society for the Advancement of Spine Surgery (ISASS) to arrive at recommendations for best clinical practices for guideline development for endoscopic spine surgery. This perspective article discusses the limitations of traditional surgical trials and amalgamates surgeons’ experience and research on various cutting-edge techniques.Methods Data were extracted from surveys conducted during each webinar session involving 3639 surgeons globally. The polytomous Rasch model was employed to analyze responses, ensuring a robust statistical assessment of surgeon endorsements and educational impacts and focusing on operative nuances and experience-based outcomes. Bias detection was performed using the differential item functioning test.Results The ISASS webinars provided a dynamic platform for discussing advances in endoscopic spine surgery, identifying a range of high-value procedures from basic discectomies to complex lumbar interbody fusions. Each high-value endoscopic spine surgery was highlighted in separate peer-reviewed publications, which form the basis for this summary document that synthesizes key takeaways from these webinars. High-value clinical applications of endoscopic spine surgery, primarily defined as higher-intensity endorsement transformation from the pre- to postwebinar survey with a shift to higher mean logit locations of test items both with unbiased and orderly threshold progression, were: (a) Percutaneous interlaminar endoscopic decompression for lateral canal stenosis, (b) transforaminal debridement of low-grade degenerative spondylolisthesis, (c) transforaminal full-endoscopic interbody fusion for hard disc herniation, (d) endoscopic standalone lumbar interbody fusion, (e) endoscopic debridement of spondylolytic spondylolisthesis, and (f) posterior cervical foraminotomy for herniated disc and bony stenosis.Conclusions The ISASS webinar series has significantly impacted surgeons’ education and contributed to the identification of high-value endoscopic spine surgery practices that may serve as a cornerstone for surgeon training standards, policy, and guidelines development. Ongoing research on technological advancements and expansions of clinical indications combined with systematic review is expected to refine the recommendations on high-value endoscopic spinal surgeries recommended for enhanced reimbursement.Clinical Relevance Assessing surgeon confidence and acceptance of endoscopic spinal surgeries using polytomous Rasch analysis.Level of Evidence Level 2 (inferential) and 3 (observational) evidence because Rasch analysis provides statistical validation of instruments rather than direct clinical outcomes.