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Original Article

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

Ho-Joong Kim1, Je-Min Yi2, Seung Hoo Lee1, Bong-Soon Chang3, Choon-Ki Lee3, Jin S. Yeom1
Journal of Advanced Spine Surgery 2014;4(1):6-10.
Published online: June 30, 2014
1Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Sungnam 463-707, Republic of Korea
2Department of Orthopaedic Surgery, Kangwon National University Hospital 156, Chuncheon, Gangwon-do 200-722, Korea
3Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehangno, Jongno- gu, Seoul 110-744, Republic of Korea
Corresponding author:  Je-Min Yi, Tel: 82-33-258-9209, Fax: 82-33-258-2149, 
Email: firekimdo@gmail.com
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Objectives
The aim of this study was to monitor the quality control of pedicle screw fixation using a cumulative summation test (CUSUM). Overview of Literature: CUSUM test has already been used in several different surgical settings including the assessment of outcomes in transplant, laparoscopic, and total hip replacement surgeries. However, there has been no data 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 screw insertion.
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 of performance 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 procedures related with spine surgery.

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Application of a Cumulative Summation test (CUSUM) in the Lumbar Spine
J Adv Spine Surg. 2014;4(1):6-10.   Published online June 30, 2014
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Application of a Cumulative Summation test (CUSUM) in the Lumbar Spine
J Adv Spine Surg. 2014;4(1):6-10.   Published online June 30, 2014
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