Application of a Cumulative Summation test (CUSUM)in the Lumbar Spine

Abstract

Study design: Retrospective analysisObjectives: The aim of this study was to monitor the quality control of pedicle screw fixation using a cumulativesummation test (CUSUM).Overview of Literature: CUSUM test has already been used in several different surgical settings including theassessment of outcomes in transplant, laparoscopic, and total hip replacement surgeries. However, there has been nodata regarding CUSUM analysis for spine surgery.Methods: Patients with lumbar spinal stenosis who underwent lumbar fusion surgery were included in this study.The primary outcome was the CUSUM analysis for monitoring the quality control of the accuracy of pedicle screwinsertion.Results: Seven screws of the 100 pedicle screw insertions were considered to have failed in the lumbar fusion surgery,respectively. Throughout the monitoring period, there was no indication by the CUSUM test that the quality ofperformance of the pedicle screw fixation procedure was inadequate.Conclusions: Thisstudy demonstrates the CUSUM test can be a useful tool for monitoring of the quality of proceduresrelated with spine surgery.