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).
Abstract:
Endoscopic spine surgery (ESS) represents a development in minimally invasive procedures, offering the potential benefits of reduced tissue disruption, shorter recovery times, and enhanced precision. This review traces the historical development of ESS, explores its core techniques-including transforaminal, interlaminar, and biportal approaches-and evaluates its role in treating conditions like herniated disks and spinal stenosis. By comparing clinical outcomes of ESS with standard open surgery, this article highlights the importance of patient selection, surgeon expertise, and evidence-based practice. Challenges, such as the steep learning curve, limitations in visualization, and risk of complications, are discussed, along with strategies for integrating ESS into modern spine care. The review concludes by identifying research gaps and opportunities for technological advancements, aiming to guide surgeons in adopting ESS and improving patient outcomes.
