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. 2019 Mar;16(1):15-23.
doi: 10.14245/ns.1938040.020. Epub 2019 Mar 31.

Endoscopic Lumbar Surgery: The State of the Art in 2019

Alexander J Butler  1 , Milad Alam  2 , Kevin Wiley  2 , Alexander Ghasem  1 , Augustus J Rush Iii  1 , Jeffrey C Wang  2
Affiliations

Endoscopic Lumbar Surgery: The State of the Art in 2019

Alexander J Butler et al. Neurospine. 2019 Mar.

Abstract

This study was aimed to provide a brief historical perspective to facilitate appreciation of current techniques, describe outcomes of endoscopic lumbar surgery relative to those of existing techniques, and identify topics in need of study and future directions for the field of endoscopic lumbar surgery. Using the PubMed database, a comprehensive search was conducted to identify peer-reviewed English language articles pertaining to endoscopic lumbar surgery. Lack of focus on pertinent techniques or lack of outcome measures constituted exclusion criteria. A majority of included articles were published from 2015–2019. A context with which to appreciate the application of endoscopic lumbar techniques is established. An abundance of case series and several recent comparison studies have documented the benefits and potential pitfalls of these methods in the past two decades. The advantages of endoscopic lumbar spine surgery are widely touted to include reduced perioperative morbidity, including blood loss, operative time and immediate postoperative recovery, minimal structural trauma resulting from surgery, generally positive patient report outcome scores and the potential to contain costs. Additional high-quality research assessing outcomes of endoscopic lumbar surgery are certainly needed and currently expected given the rapid expansion of the field in recent years.

Keywords: Discectomy; Endoscopic spine surgery; Endoscopy; Lumbar spine surgery; Minimally invasive surgery; Technology.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

Fig. 1.
Fig. 1.
Schematic depicting Kambin triangle, the anatomic space bound by the caudal vertebral body (base), the traversing nerve root (height), and exiting nerve root (hypotenuse) at a given neuroforamen.
Fig. 2.
Fig. 2.
Demonstration of instrumentation positioning and corresponding intraoperative fluoroscopic view (A) of the unilateral biportal technique. The surgeon holds the endoscope in his left hand (B) which corresponds to the blue viewing portal (C). Instruments in the surgeon’s right hand (B) may be passed through the red working portal (C).
Fig. 3.
Fig. 3.
Flowchart depicting article selection process accounting for inclusion in review of all referenced articles.
See this image and copyright information in PMC

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