Current Practice and Evidence for Endoscopic Spine Surgery
Kai-Uwe Lewandrowski1, Jason Pittman, Sam Joseph
1From the Division Personalized Pain Research and Education, Center for Advanced Spine Care of Southern Arizona, Tucson, AZ (Lewandrowski), University of Arizona, Banner Medical Center, Tucson, AZ (Lewandrowski), Department of Orthopaedics, Fundación Universitaria Sanitas Bogotá D.C. Colombia (Lewandrowski), Dr. honoris causa Department of Orthopedics at Hospital Universitário Gaffree Guinle Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil, Foreign Corresponding Member of Colombian National Academy of Medicine, Foreign Corresponding Member of the Brazilian Military Medical Academy, President Interamerican Society For Minimally Invasive Spine Surgery (SICCMI) (Lewandrowski), the Department of Orthopedic Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA (Pittman), HCA/USF Department of Orthopaedic Surgery, Joseph Spine Institute, Tampa, FL (Joseph), Excel Spine Center, UCSD Medical Center East Campus, Minimally Invasive Center of Excellence, San Diego, CA (Kim), Desert Institute For Spine Care, Phoenix, AZ (Yeung), and the Department of Orthopaedic Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA (Vaccaro).
Endoscopic spine surgery (ESS) offers benefits like faster recovery and less disruption. This review details ESS techniques, applications, and challenges for improved patient care.
Area of Science:
- Neurosurgery
- Minimally Invasive Procedures
Background:
- Endoscopic spine surgery (ESS) is an evolving minimally invasive technique.
- It aims to reduce tissue disruption and speed up recovery.
Purpose of the Study:
- To review the historical development and techniques of ESS.
- To evaluate ESS for conditions like herniated discs and spinal stenosis.
- To compare ESS outcomes with open surgery.
Main Methods:
- Review of historical development and core ESS techniques (transforaminal, interlaminar, biportal).
- Evaluation of ESS in treating herniated discs and spinal stenosis.
- Comparison of clinical outcomes between ESS and open spine surgery.
Main Results:
- ESS demonstrates potential for reduced tissue disruption, shorter recovery, and enhanced precision.
- Key factors for success include patient selection, surgeon expertise, and evidence-based practice.
- Challenges include a steep learning curve, visualization limits, and potential complications.
Conclusions:
- ESS is a valuable advancement in spine surgery with specific benefits.
- Careful integration into practice, addressing challenges, is crucial for optimal patient outcomes.
- Further research and technological advancements are needed to refine ESS applications.
