Scholarlink

Study design <p>Retrospective cohort study.</p> Objectives <p>To evaluate surgical consistency and clinical outcomes in intramedullary ependymoma (WHO grade II) cases by using X-bar charts as a tool to assess procedural stability.</p> Setting <p>The single institution in Japan.</p> Methods <p>This study included patients who underwent resection of intramedullary ependymomas between 2001 and 2023. All surgeries were performed by one of five board-certified spine surgeons. Operative time was analyzed for stability using X-bar charts. Neurological outcomes were assessed using the modified McCormick Scale (mMS), and regression analysis was performed to evaluate the relationship between operative time and mMS.</p> Results <p>The study included 144 patients (82 men, 62 women; average age 50.3 ± 14.6 years). Tumors were located at cervical (67.4%) or thoracic (32.6%) levels, averaging 3.0 ± 1.2 vertebrae. The surgeon who performed 71 cases was defined as the experienced surgeon, and the other surgeons performed 10–24 cases, respectively. The mean operative time was 380.6 ± 140.7 min, and 135 cases achieved gross total resection. The average follow-up duration was 6.9 ± 3.9 years. X-bar charts showed surgical stability once the average number of cases exceeded 17. No significant correlation was found between operative time and mMS for any surgeon. Perioperative complications were minimal.</p> Conclusions <p>X-bar charts are a valuable tool for objectively evaluating surgical stability. In intramedullary ependymoma surgeries, consistency in operative time was achieved after 17 cases, and longer procedures did not adversely affect neurological outcomes. This method could be extended to monitor procedural reliability in other complex surgical interventions.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

How many cases of spinal intramedullary ependymoma surgery are required to achieve stability? - Analysis using X-bar charts

  • 期刊论文

  • 发表日期：

    2025年5月21日

查看全文
  • Narihito Nagoshi,
  • Kengo Nagashima,
  • Toshiki Okubo,
  • Masahiro Ozaki,
  • Satoshi Suzuki,
  • Kazuki Takeda,
  • Takahito Iga,
  • Morio Matsumoto,
  • Masaya Nakamura,
  • Kota Watanabe

摘要

Study design

Retrospective cohort study.

Objectives

To evaluate surgical consistency and clinical outcomes in intramedullary ependymoma (WHO grade II) cases by using X-bar charts as a tool to assess procedural stability.

Setting

The single institution in Japan.

Methods

This study included patients who underwent resection of intramedullary ependymomas between 2001 and 2023. All surgeries were performed by one of five board-certified spine surgeons. Operative time was analyzed for stability using X-bar charts. Neurological outcomes were assessed using the modified McCormick Scale (mMS), and regression analysis was performed to evaluate the relationship between operative time and mMS.

Results

The study included 144 patients (82 men, 62 women; average age 50.3 ± 14.6 years). Tumors were located at cervical (67.4%) or thoracic (32.6%) levels, averaging 3.0 ± 1.2 vertebrae. The surgeon who performed 71 cases was defined as the experienced surgeon, and the other surgeons performed 10–24 cases, respectively. The mean operative time was 380.6 ± 140.7 min, and 135 cases achieved gross total resection. The average follow-up duration was 6.9 ± 3.9 years. X-bar charts showed surgical stability once the average number of cases exceeded 17. No significant correlation was found between operative time and mMS for any surgeon. Perioperative complications were minimal.

Conclusions

X-bar charts are a valuable tool for objectively evaluating surgical stability. In intramedullary ependymoma surgeries, consistency in operative time was achieved after 17 cases, and longer procedures did not adversely affect neurological outcomes. This method could be extended to monitor procedural reliability in other complex surgical interventions.