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Related Experiment Video

Updated: Aug 4, 2025

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
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Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

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Surgeon reported practice patterns related to full endoscopic cervical decompression procedures.

Vincent Hagel1,2, Ralf Wagner3, Albrecht Waschke4

  • 1University Spine Center Zürich, Balgrist University Hospital, Zurich, Switzerland. vhagel@yahoo.de.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|April 5, 2023
PubMed
Summary

Fear of complications and lack of mentorship hinder cervical endoscopic spine surgery adoption. Many surgeons are hesitant despite its growing popularity, highlighting a need for better training and support.

Keywords:
Cervical central stenosisCervical disc herniationCervical endoscopic spine surgeryCervical foraminal stenosis

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Area of Science:

  • Minimally Invasive Spine Surgery
  • Cervical Spine Surgery
  • Surgical Techniques

Background:

  • Microsurgical anterior cervical spine approaches are common, but posterior approaches are less frequent due to bleeding and complication risks.
  • Endoscopic techniques are often preferred via the posterior approach, yet many surgeons are reluctant to adopt them for cervical spine procedures.
  • This study investigates the reasons behind surgeon reluctance towards cervical endoscopic spine surgery.

Purpose of the Study:

  • To survey spine surgeons regarding their practice patterns and perceptions of microscopic versus endoscopic spine surgery in the lumbar and cervical spine.
  • To identify the primary barriers preventing wider adoption of endoscopic techniques in cervical spine surgery.

Main Methods:

  • A 10-question survey was distributed via email and social media to spine surgeons.
  • Responses were collected on practice patterns, demographic data, and reasons for performing or not performing cervical endoscopic surgery.
  • Statistical analysis included cross-tabulation, Pearson Chi-Square, Kappa statistics, and linear regression.

Main Results:

  • The survey had a 39.7% response rate (50 completed questionnaires).
  • Half of the respondents perform routine endoscopic cervical spine surgery; the other half cited fear of complications (50%) and lack of mentorship (25.4%) as major hurdles.
  • Perceived lack of technology (20.8%) and suitable indications (12.5%) were also concerns, with only 4.2% deeming it too risky.

Conclusions:

  • Cervical endoscopic spine surgery is gaining acceptance, particularly among surgeons in private practice who are self-taught.
  • Fear of complications and the absence of formal mentorship are significant impediments to the broader implementation of cervical endoscopic procedures.
  • Addressing these barriers is crucial for advancing the use of minimally invasive endoscopic techniques in cervical spine surgery.