Skip to main navigation Skip to main content
  • E-Submission
  • Contact us

NS : Neurospine

OPEN ACCESS
Search
Advanced Search
ABOUT
BROWSE ARTICLES
FOR AUTHORS

Page Path

49
results for

"Endoscopy"

Article category

More +

Publication year

More +

Keywords

More +

Authors

More +

Funded articles

More +

"Endoscopy"

Original Articles

Artificial Intelligence

Domain-Adapted Foundation Models for Single-Click Surgical Instrument Segmentation in Spinal Endoscopy
Bong-Su Mun, Zhi Zhao, Sang-Min Park, Jiwon Park, Hyun-Jin Park, Hyung Rae Lee, Ho-Joong Kim, Jin S. Yeom
Neurospine 2026;23(3):633-643.   Published online July 31, 2026
DOI: https://doi.org/10.14245/ns.26520632.0316

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

Include:

Domain-Adapted Foundation Models for Single-Click Surgical Instrument Segmentation in Spinal Endoscopy
Neurospine. 2026;23(3):633-643.   Published online July 31, 2026
DOI: https://doi.org/10.14245/ns.26520632.0316
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
Format:
Include:
Domain-Adapted Foundation Models for Single-Click Surgical Instrument Segmentation in Spinal Endoscopy
Neurospine. 2026;23(3):633-643.   Published online July 31, 2026
DOI: https://doi.org/10.14245/ns.26520632.0316
Close
Objective
Accurate segmentation of surgical instruments in endoscopic images is essential for developing computer-assisted surgical systems, yet creating annotated training datasets remains labor-intensive. This study aimed to evaluate the efficiency of point-based interactive segmentation using foundation models for surgical instrument annotation in spinal endoscopy.
Methods
We conducted a retrospective study comparing point-based segmentation performance between Segment Anything Model (SAM) 2.0, SAM 2.1, and domain-adapted MedSAM 2.1 for surgical instrument segmentation in spinal endoscopy. A test set of 308 images from 10 patients undergoing full-endoscopic lumbar decompression/discectomy or biportal endoscopic decompression/discectomy was evaluated. Models were assessed using standardized point prompts placed at the ground truth mask centroid. Primary outcomes included Dice similarity coefficient at single-click and success rate (Dice≥0.85). Secondary analysis evaluated click-to-quality metrics across iterative refinement up to 10 clicks.
Results
At single-click, MedSAM 2.1 achieved significantly higher Dice scores than SAM 2.1 (0.937±0.074 vs. 0.844±0.222, p<0.001; 95% confidence interval [CI] for difference, 0.070–0.116) and SAM 2.0 (0.937±0.074 vs. 0.824±0.236, p<0.001; 95% CI for difference, 0.088–0.138), with a 3-fold reduction in variability (standard deviation: 0.074 vs. 0.222). External validation on the publicly available Spine Endoscopic Atlas dataset (202 images from 10 patients) confirmed generalizability, with MedSAM 2.1 achieving Dice 0.918±0.083, compared to 0.724±0.281 for SAM 2.1 and 0.708±0.290 for SAM 2.0 (both p<0.001). Interrater agreement between 2 independent annotators demonstrated excellent reliability (intraclass correlation coefficient, 0.991; 95% CI, 0.986–0.994; mean pairwise Dice, 0.953±0.051). The MedSAM 2.1-assisted workflow reduced annotation time by 75.8% compared to manual polygon annotation (7.7±13.3 seconds vs. 31.8±18.2 seconds per image; p<0.001; 4.1-fold speedup). SAM 2.1 improved progressively with additional clicks (Dice 0.844 to 0.943 at 10 clicks), while MedSAM 2.1 showed nonmonotonic progression (0.937 to 0.947), indicating near-optimal first-click predictions.
Conclusion
Domain-adapted MedSAM 2.1 improved single-click annotation accuracy and efficiency for surgical instruments in spinal endoscopy, suggesting that low-resource domain adaptation may facilitate institutional dataset construction for surgical artificial intelligence research.
  • 948 View
  • 29 Download

Minimally Invasive Surgery

Biportal Endoscopic Techniques for Severe Dural Ossification in Thoracic Ossification of the Ligamentum Flavum: Insights From Preoperative Imaging
Ji Yeon Kim, Su Yong Choi, Dong Chan Lee, Hyeun Sung Kim, Dong Hwa Heo
Neurospine 2025;22(3):819-828.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550338.169

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

Include:

Biportal Endoscopic Techniques for Severe Dural Ossification in Thoracic Ossification of the Ligamentum Flavum: Insights From Preoperative Imaging
Neurospine. 2025;22(3):819-828.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550338.169
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
Format:
Include:
Biportal Endoscopic Techniques for Severe Dural Ossification in Thoracic Ossification of the Ligamentum Flavum: Insights From Preoperative Imaging
Neurospine. 2025;22(3):819-828.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550338.169
Close
Objective
This study evaluates surgical strategies based on preoperative computed tomography (CT) findings during unilateral biportal endoscopic (UBE) surgery for thoracic ossification of the ligamentum flavum (OLF) with dural ossification.
Methods
This retrospective study included patients undergoing posterior thoracic laminectomy via UBE surgery to treat symptomatic thoracic stenosis due to OLF. Clinical outcomes were assessed using visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) scores, alongside analyses of preoperative CT and intraoperative videos for dural ossification characteristics.
Results
A total of 34 patients participated, showing significant improvements in VAS and JOA scores postoperatively. All focal dural ossifications exhibiting the tram-track sign were effectively excised without significant dural defects. The circumferential floating technique was employed for cases with the bridge sign, whereas wide excision was warranted for those with the comma sign.
Conclusion
UBE surgery effectively manages progressive thoracic OLF associated with dural ossification. Preoperative CT imaging is essential for assessing dural involvement and guiding surgical techniques. Microscopic surgery is recommended for inexperienced surgeons requiring wide dural excision.

Citations

Citations to this article as recorded by  Crossref logo
  • The Safety and Efficacy of Unilateral Biportal Endoscopic Decompression for the Treatment of Thoracic Ossification of Ligamentum Flavum with Occupancy Ratio > 60%: A Retrospective Cohort Study
    Lei Qi, Biteng Xu, Xiangji Guo, Gaoya Yu, Yuxuan Yang, Haozhi Yu, Liang Wang
    Pain and Therapy.2026; 15(1): 379.     CrossRef
  • Biportal endoscopic spinal surgery for thoracic ossification of the ligamentum flavum: a study of different classification types and surgical outcomes
    Honggang Wang, Dongqing He, Ruxing Liu, Jie Yuan, Yongfeng Wang
    Frontiers in Neurology.2026;[Epub]     CrossRef
  • Radiologic and clinical outcomes of unilateral biportal endoscopic decompression for thoracic ossification of the ligamentum flavum
    Sang-Woo Lee, JinWoo Jung, Sang-Kyu Son, Man-Kyu Park
    European Spine Journal.2026;[Epub]     CrossRef
  • 9,792 View
  • 116 Download
  • 5 Web of Science
  • 3 Crossref
Intra-, Epidural And Intracranial Pressure Changes During Interlaminar Endoscopy, With and Without Dural Tear
Mazda Farshad, Jana Felicitas Schader, Alexandra Stauffer, Carl Moritz Zipser, Najmeh Kheram, José Miguel Spirig, Marie-Rosa Fasser, Jonas Widmer, Vincent Hagel
Neurospine 2025;22(2):583-591.   Published online June 30, 2025
DOI: https://doi.org/10.14245/ns.2550456.228

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

Include:

Intra-, Epidural And Intracranial Pressure Changes During Interlaminar Endoscopy, With and Without Dural Tear
Neurospine. 2025;22(2):583-591.   Published online June 30, 2025
DOI: https://doi.org/10.14245/ns.2550456.228
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
Format:
Include:
Intra-, Epidural And Intracranial Pressure Changes During Interlaminar Endoscopy, With and Without Dural Tear
Neurospine. 2025;22(2):583-591.   Published online June 30, 2025
DOI: https://doi.org/10.14245/ns.2550456.228
Close
Objective
Endoscopic spine surgery implies possibly severe complications of the central nervous system, from headache to seizures and autonomic dysreflexia. These adverse events might be due to increased intracranial pressure (ICP), presumably induced by increased spinal intra-/epidural pressure caused by fluid irrigation. This study was designed to perform interlaminar endoscopic lumbar discectomy (IELD) at different irrigation fluid settings while monitoring its effect on intra-/epidural and ICPs, with and without dural tears.
Methods
Spinal intradural pressures were measured by introducing catheters through a sacral approach to human cadavers’ lumbar, thoracic, and cervical levels. Additionally, an epidural probe was placed at L3–4. ICP was measured by an intraventricular probe. IELD was performed at L3–4, and the effect of varying irrigation pressures by different endoscopic pump systems and gravity-based irrigation on intra-/epidural and ICP pressures was measured before and after durotomy at L3–4.
Results
Intradural pressure at L3–4 correlated linearly with increasing irrigation pressure, irrespective of the used pump system (median pressure increase at 100-mmHg irrigation pressure: system I: 7 mmHg, r=0.94, p=0.002; system II: 7 mmHg, r=0.89, p=0.017) or gravity (8 mmHg, r=0.93, p=0.242). This effect was also seen intradurally at the thoracic/cervical spine, epidural, and intracranial level, and was even more pronounced with the maneuver of outflow-occlusion and a dural tear present.
Conclusion
While performing IELD, pump pressures correlated linearly to intra-/epidural pressures and ICPs. Pressures did not rise to concerningly high levels without outflow-occlusion, even with increased pump pressures. In the presence of a dural tear, higher pump pressures exacerbated by occlusion may lead to deleterious intradural and ICP elevations.

Citations

Citations to this article as recorded by  Crossref logo
  • Preliminary Report of Full-Endoscopic Spinal Dural Repair Using Double-Arm Sutures With a Biportal Endoscopic System: Technical Note and Feasibility Evaluation in an Ex Vivo Porcine Model
    Kuo-Hua Chao, Chiu-Ming Chen, Jui-Jung Yang
    Operative Neurosurgery.2026; 31(1): 144.     CrossRef
  • Biportal endoscopic foraminotomy of the L7–S1 neuroforamen in dogs: Description of surgical technique and ex vivo comparison with conventional open dorsolateral foraminotomy
    Dimitrios Bekiaridis, Antonio Pozzi, Frank Steffen, Julian Guevar, Lucas A. Smolders
    Veterinary Surgery.2026; 55(4): 837.     CrossRef
  • A Protocol to Preserve the Dural Safety Margin During Simultaneous Hybrid Lumbar Unilateral Biportal Endoscopy and Cervical Laminoplasty
    Karson Tam, H.Y. Li, H.K. Lo, W.L. Kam
    World Neurosurgery.2026; 209: 124877.     CrossRef
  • Epidemiology of spinal cord hypertension syndrome in water-mediated uniportal full endoscopic thoracolumbar surgery: a single-center experience
    Haiyang Wu, Luyang Wang, Yiping Zheng, Xizhong Zhu, Wanqi Ren, Ziheng Li, Shoule Ma, Mingwang Zhao, Xingchen Li, Yusheng Xu
    European Spine Journal.2026;[Epub]     CrossRef
  • Validation of the VIEW score: a novel intraoperative grading scale for visualization in endoscopic spine surgery
    Vit Kotheeranurak, Surachat Jaroenwareekul, Jin-Sung Kim, Christoph Siepe, Don Young Park, Javier Quillo-Olvera, Worawat Limthongkul, Wicharn Yingsakmongkol, Weerasak Singhatanadgige
    European Spine Journal.2026;[Epub]     CrossRef
  • ADAMKIEWICZ’S ARTERY IN ENDOSCOPIC SURGERY: NARRATIVE REVIEW
    Ricardo Rezende Campos, Charbel Jacob Junior, Marcelo Botelho Soares de Brito, Jorge Felipe Ramírez León2, Gabriel Oswaldo Alonso Cuéllar, Sonja Ellen Lobo, João Paulo Machado Bergamaschi
    Coluna/Columna.2026;[Epub]     CrossRef
  • Short term complications and risk factors of unilateral biportal endoscopic cervical spine surgery in patients with cervical radiculopathy and myelopathy: a single center retrospective study
    Chengyue Zhu, Xinning Mao, Zhongshu Shan, Donghao Du, Jiaming Liang, Junfeng Shen, Hao Pan, Wei Zhang, Fangcai Li
    Frontiers in Medicine.2026;[Epub]     CrossRef
  • Pneumocephalus with suspected cerebrospinal fluid leakage after epiduroscopic epidural neuroplasty: a case report
    Min Jeong Kang, Bo Kyung Kang, Seung Hee Yoo, Won-joong Kim
    Ewha Medical Journal.2026; 49(3): e23.     CrossRef
  • Biportal Endoscopic Transforaminal Approach for Midthoracic Calcified Herniated Disc: A Case Report and Technical Note
    Young-Il Ko, Hun-Chul Kim, Jin-Young Lee
    Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(Suppl 2): S343.     CrossRef
  • Intracranial, Intra-, and Epidural Pressure Changes During Endoscopic Lumbar Discectomy
    Alexandra Stauffer, Jana F. Schader, Carl M. Zipser, Najmeh Kheram, Marie-Rosa Fasser, José M. Spirig, Jonas Widmer, Vincent Hagel, Mazda Farshad
    Spine.2026; 51(20): E530.     CrossRef
  • 7,764 View
  • 190 Download
  • 10 Web of Science
  • 10 Crossref
Biportal Endoscopic Decompression for Degenerative Lumbar Spondylolisthesis With Stenosis
Wongthawat Liawrungrueang, Ho-Jin Lee, Sang Bum Kim, Sang-Min Park, Hyun-Jin Park
Neurospine 2025;22(2):556-565.   Published online June 30, 2025
DOI: https://doi.org/10.14245/ns.2449354.677

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

Include:

Biportal Endoscopic Decompression for Degenerative Lumbar Spondylolisthesis With Stenosis
Neurospine. 2025;22(2):556-565.   Published online June 30, 2025
DOI: https://doi.org/10.14245/ns.2449354.677
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
Format:
Include:
Biportal Endoscopic Decompression for Degenerative Lumbar Spondylolisthesis With Stenosis
Neurospine. 2025;22(2):556-565.   Published online June 30, 2025
DOI: https://doi.org/10.14245/ns.2449354.677
Close
Objective
This study aimed to evaluate the clinical and radiological outcomes of unilateral laminotomy for bilateral decompression (ULBD) using biportal endoscopic spinal surgery (BESS) in patients with central canal stenosis, with and without low-grade degenerative lumbar spondylolisthesis (DLS).
Methods
A retrospective observational study was conducted on 170 patients who underwent BESS-ULBD between 2015 and 2018, with at least 2 years of follow-up. Patients were categorized into 2 groups: group A (68 patients) with central stenosis and low-grade DLS and group B (102 patients) with central stenosis alone. Clinical outcomes were assessed using the visual analogue scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and Modified MacNab criteria. Radiological assessments included sagittal translation measurements on dynamic flexion-extension radiographs.
Results
Both groups significantly improved clinical outcomes at the final follow-up (p<0.05). Group A’s mean VAS scores improved from 3.8±2.4 to 1.9±2.0 for back pain and from 6.4±1.8 to 2.3±2.0 for leg pain. In group B, back pain improved from 3.9±2.5 to 1.7±1.9, and leg pain from 6.6±2.0 to 2.2±2.2. ODI scores also improved significantly in both groups. Radiological evaluation showed no significant changes in sagittal translation postoperatively, indicating preserved spinal stability. Both groups had comparable clinical outcomes, with no major complications reported.
Conclusion
BESS-ULBD is a safe and effective minimally invasive option for managing central canal stenosis, with or without low-grade DLS. This technique provides substantial symptom relief, preserves spinal stability, and presents a promising alternative to more invasive fusion procedures in carefully selected patients.

Citations

Citations to this article as recorded by  Crossref logo
  • Future Directions in the Treatment of Lumbar Spondylolisthesis
    Parikshit Juvekar, Susan Christopher, Zoher Ghogawala
    Neurosurgery Clinics of North America.2026; 37(1): 143.     CrossRef
  • Trends in Utilization and Cost of Endoscopic Lumbar Decompression in Ambulatory Surgical Centers: A Nationwide Database Analysis From 2018 Through 2022
    Mitchell K. Ng, Paul G. Mastrokostas, Leonidas E. Mastrokostas, Aaron B. Lavi, Luke B. Schwartz, Yasmine K. Eichbaum, Yulia Lee, Morgan Hitchner, William Green, Gregorio Baek, Joshua Mathew, Jonathan Dalton, Alec Giakas, Rajendra Singh, Afshin E. Razi, Ia
    Global Spine Journal.2026; 16(5): 2252.     CrossRef
  • A Commentary on “International Practice Patterns in the Surgical Management of Primary Lumbar Disc Herniation: An AO Spine Cross-Sectional Study”
    Jin-Sung Kim
    Neurospine.2026; 23(1): 40.     CrossRef
  • Response to the letter to the editor: Inconsistencies in obesity criteria: implications for systematic reviews on endoscopic spine surgery
    Wongthawat Liawrungrueang, Watcharaporn Cholamjiak, Peem Sarasombath, Yudha Mathan Sakti, Pang Hung Wu, Meng-Huang Wu, Yu-Jen Lu, Lo Cho Yau, Zenya Ito, Sung Tan Cho, Dong-Gune Chang, Kang Taek Lim
    Asian Spine Journal.2026; 20(1): 211.     CrossRef
  • Targeted Decompression Under Local Anesthesia versus Extensive Decompression Under General Anesthesia for Octogenarians with Lumbar Degenerative Diseases: A Real-World Propensity Score-Matched Analysis
    Hang Zhang, Huili Cai, Yunzhong Cheng, Xuelin Li, Yang Liu, Fengping Liu, Jingchuan Sun, Haidan Chen
    Clinical Interventions in Aging.2026; Volume 21: 1.     CrossRef
  • Application of minimally invasive decompression interventions for the surgical treatment of degenerative lumbar spondylolysthesis
    P. Remov, A. Babkin, S. Zalepugin, A. Mazurenko, S. Jurchenko, A. Malashenko, A. Kartyzhova, Yu. Aniskevich, D. Sackevich
    Healthcare.2026; (5): 4.     CrossRef
  • Impact of Concomitant Grade I Degenerative Spondylolisthesis on Clinical and Radiographic Outcomes Following Biportal Endoscopic versus Microscopic Laminectomy for Lumbar Spinal Stenosis: A Post Hoc Analysis of a Multicenter Randomized Clinical Trial
    Hyun-Jin Park, Min-Seok Kang, Kwang-Sup Song, Dae-Woong Ham, Ho-Joong Kim, Ki-Han You, Seung-Yeon Jeong, Jin-Sung Kim, Sang-Min Park
    Global Spine Journal.2026;[Epub]     CrossRef
  • Cost-effectiveness analysis of the early transition from microscopic to biportal endoscopic unilateral laminectomy bilateral decompression
    Sung-Eun Kwon, Hangeul Park, Noah Hong, Woojin Kim, Jungbo Sim, Ho Sung Myeong, Seunghoon Lee, Jun-Hoe Kim, Chang-Hyun Lee, Fon-Yih Tsuang, Chi Heon Kim
    Medicine.2026; 105(34): e50400.     CrossRef
  • Endoscopic decompression alone for lumbar spinal stenosis with degenerative spondylolisthesis: a systematic review and meta-analysis of paired change scores
    Aashish Ghodke, Oliver Hadfield, Satish Rohra, Birender Balain
    European Spine Journal.2026;[Epub]     CrossRef
  • Advancing Endoscopic Decompression in Degenerative Lumbar Spondylolisthesis – A Commentary on “Biportal Endoscopic Decompression for Degenerative Lumbar Spondylolisthesis With Stenosis”
    Jin-Sung Kim
    Neurospine.2025; 22(2): 566.     CrossRef
  • Clinical outcomes of navigation-assisted versus fluoroscopy-guided UBE-ULBD in single-level lumbar spinal stenosis: a retrospective study
    Shi-Jie Liu, Si-Yuan Yao, Yao Zhang, Wan-Cheng lin, Li-Xiang Ding, Ji-Peng Song
    BMC Surgery.2025;[Epub]     CrossRef
  • 9,535 View
  • 173 Download
  • 11 Crossref

Minimally Invasive Spine Surgery

Far-Lateral Transforaminal Unilateral Biportal Endoscopic Lumbar Discectomy for Upper Lumbar Disc Herniations
Jin Seop Hwang, Sang Hyub Lee, Dain Jeong, Jae-Won Jang, Yong Eun Cho, Dong-Geun Lee, Choon Keun Park, Chung Kee Chough
Neurospine 2025;22(1):14-27.   Published online March 31, 2025
DOI: https://doi.org/10.14245/ns.2550058.029

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

Include:

Far-Lateral Transforaminal Unilateral Biportal Endoscopic Lumbar Discectomy for Upper Lumbar Disc Herniations
Neurospine. 2025;22(1):14-27.   Published online March 31, 2025
DOI: https://doi.org/10.14245/ns.2550058.029
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
Format:
Include:
Far-Lateral Transforaminal Unilateral Biportal Endoscopic Lumbar Discectomy for Upper Lumbar Disc Herniations
Neurospine. 2025;22(1):14-27.   Published online March 31, 2025
DOI: https://doi.org/10.14245/ns.2550058.029
Close
Objective
The upper lumbar region has distinctive anatomical characteristics that contribute to the challenges of performing discectomy. We introduce far-lateral transforaminal unilateral biportal endoscopic (UBE) lumbar discectomy for central or paracentral disc herniations in the upper lumbar region.
Methods
We conducted retrospective review of the patients who underwent a far-lateral transforaminal UBE lumbar discectomy at our institution from January 2018 to September 2024. The electronic medical records, operative records, and radiologic images of the patients were reviewed.
Results
A total of 27 patients underwent far-lateral transforaminal UBE lumbar discectomy for central or paracentral disc herniations in the upper lumbar region. The patient had a mean age of 54.0 ± 13.7 years. Operation was performed at the L1–2 level in 3 patients (11.1%), L2–3 in 9 patients (33.3%), and L3–4 in 15 patients (55.6%). The patients were followed-up for a mean of 27.7 ± 19.3 months. The Oswestry Disability Index was significantly decreased from 36.3 ± 6.8 preoperatively to 3.7 ± 3.3 at last follow-up (p < 0.001). The visual analogue scale (VAS) back was significantly decreased from 7.8 ± 0.9 preoperatively to 3.1 ± 0.6 postoperative day 2 (p < 0.001). The VAS leg was significantly decreased from 8.1 ± 0.8 preoperatively to 2.3 ± 0.7 postoperative day 2 (p < 0.001).
Conclusion
The far-lateral transforaminal UBE lumbar discectomy would be a viable surgical option for upper lumbar disc herniations.

Citations

Citations to this article as recorded by  Crossref logo
  • Unilateral Biportal Endoscopic Transforaminal Lumbar Interbody Fusion (TLIF) Using 3-Dimensional-Printed Titanium Cages Compared With Open TLIF: A Comparison of Clinical Outcomes and Fusion Rates
    Sang Hyub Lee, Junghan Seo, Dain Jeong, Sang Youp Han, Dong Hyun Lee, Jae-Won Jang, Dong-Geun Lee, Choon Keun Park
    Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(Suppl 1): S28.     CrossRef
  • The efficacy and safety of annulus fibrosus suture as adjuvant therapy for lumbar disc herniation: a systematic review and meta-analysis
    Wensi Ouyang, Guimei Guo, Yu Sun, Haobo Jiang, Long Chen, Shaofeng Yang
    Frontiers in Bioengineering and Biotechnology.2026;[Epub]     CrossRef
  • Nerve Root Herniation Due to Delayed Dural Tear Following Unilateral Laminotomy for Bilateral Decompression With Lumbar Discectomy Using Unilateral Biportal Endoscopy
    Sang Hyub Lee, Jae-Won Jang, Yong Eun Cho, Choon Keun Park
    Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(Suppl 1): S109.     CrossRef
  • Application of the far-lateral approach in uni-portal non-coaxial spinal endoscopic surgery: an evidence-based and Delphi consensus approach among Chinese expert opinions
    Mengchen Yin, Yongpeng Lin, Pengfei Yu, Dong Wang, Fengtao Li, Shiyuan Hao, Kening Sun, Kuankuan Li, Yun Liu, Xin Zhang, Jizheng Li, Mingfei Wang, Junming Ma, Wenlong Yu, Li Xue, Zhilin Li, Guodong Gao, Bo Zhang, Benhui Xu, Jing Feng, Chao Chen, Yiguo Yan
    Brain and Spine.2026; 6: 105994.     CrossRef
  • The influence of the positional relationship between the pedicle and the pars interarticularis on unilateral biportal endoscopy: A retrospective cohort study
    Shaoning Shen, Tingyuan Lai, Hao Wei, Wangnan Mao, Lianguo Wu, Hanbing Zeng
    Medicine.2026; 105(12): e47945.     CrossRef
  • Comparison of short-term clinical efficacy between percutaneous endoscopic transforaminal discectomy and unilateral biportal endoscopy in the treatment of upper lumbar disc herniation
    Jing Zhang, Zhinan Ren, Lei Yu, Cheng Peng, Yingjie Hao
    BMC Musculoskeletal Disorders.2026;[Epub]     CrossRef
  • Incidence and Risk Factors for 30- and 90-day Reoperations Following Biportal Endoscopic Lumbar Discectomy for Single-Level Lumbar Disc Herniations
    Sang Hyub Lee, Jae-Won Jang, Hangyu Lee, Limjoon Yoon, Sejin Song, Dain Jeong, Junghan Seo, Sang Youp Han, Bang-Sang Hahn, Jun Young Kim, Jin Seop Hwang, Dong-Geun Lee, Jin-Sung Kim, Dong Chan Lee, Yong Eun Cho, Choon Keun Park
    Global Spine Journal.2026;[Epub]     CrossRef
  • Clinical Efficacy and Learning Curve of Far‐Lateral Approach (FLA) in Uni‐Portal Non‐Coaxial Spinal Endoscopic Surgery (UNSES) in the Treatment of Lumbar Degenerative Diseases: A Prospective Study
    Mengchen Yin, Wenlong Yu, Yan Lou, Jianfeng Sha, Yang Xue, Dong Zhang, Kaipeng Huang, Kai Lv, Zhichao Ge, Jianmin Li, Jiajun Wu, Hao Sun, Shuqiang Wang
    Orthopaedic Surgery.2026; 18(9): 1972.     CrossRef
  • Clinical outcomes of uni-portal non-coaxial spinal endoscopic surgery for severe caudally migrated lumbar disc herniation with free fragments
    Hongshun Zhao, Shihao Zhou, Tianluo Guo, Jianpeng Zheng, Ying Wei, Chuanhai Lin, Liuyue Sunxin, Wenyu Niu, Junhao Sun, Zhihua Xu, En Song, Jiancuo A
    Frontiers in Surgery.2026;[Epub]     CrossRef
  • Unilateral biportal endoscopy versus percutaneous transforaminal endoscopic discectomy for far lateral lumbar disc herniation: a systematic review and meta-analysis
    Kaiyuan Lin, Xiaojun Yu, Shanxi Wang, Ye Tian, Jianbin Guan
    EFORT Open Reviews.2026; 11(10): 1119.     CrossRef
  • Bilateral–Contralateral Endoscopic Decompression as a Fusion-Deferral Strategy in Upper Lumbar Stenosis: A Structural Rationale and Conditional Framework—A Technical Note with Cases Review
    Dong Hyun Lee, Sang Yeop Han, Seung Young Jeong, Il-Tae Jang
    Journal of Clinical Medicine.2025; 14(16): 5726.     CrossRef
  • 13,591 View
  • 529 Download
  • 13 Web of Science
  • 11 Crossref

Review Article

The Utilization of Navigation and Emerging Technologies With Endoscopic Spine Surgery: A Narrative Review
Abhinav K. Sharma, Rafael Garcia de Oliveira, Siravich Suvithayasiri, Piya Chavalparit, Chien Chun Chang, Yong H. Kim, Charla R. Fischer, Sang Lee, Samuel Cho, Jin-Sung Kim, Don Young Park
Neurospine 2025;22(1):105-117.   Published online March 31, 2025
DOI: https://doi.org/10.14245/ns.2449404.702

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

Include:

The Utilization of Navigation and Emerging Technologies With Endoscopic Spine Surgery: A Narrative Review
Neurospine. 2025;22(1):105-117.   Published online March 31, 2025
DOI: https://doi.org/10.14245/ns.2449404.702
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
Format:
Include:
The Utilization of Navigation and Emerging Technologies With Endoscopic Spine Surgery: A Narrative Review
Neurospine. 2025;22(1):105-117.   Published online March 31, 2025
DOI: https://doi.org/10.14245/ns.2449404.702
Close
Endoscopic spine surgery (ESS) is growing in popularity worldwide. An expanding body of literature demonstrates rapid functional recovery with reduced morbidity compared to open techniques. Both full endoscopic spine surgery, or uniportal endoscopy, and unilateral biportal endoscopy (UBE) can be employed in conjunction with various navigation and enabling technologies for assistance with localization of anatomic orientation and assessment of the intraoperative target spinal pathology. This review article describes various navigation technologies in ESS, including 2-dimensional (2D) fluoroscopic imaging, 2D fluoroscopic navigation, 3-dimensional C-arm navigation, augmented reality, and spinal robotics. Employment of enabling navigation and emerging technology with the registration of patient-specific anatomy enables clear delineation of anatomic landmarks and facilitation of a successful procedure. Additionally, avoidance of common pitfalls during use of navigation systems in ESS is discussed in this review.

Citations

Citations to this article as recorded by  Crossref logo
  • Lumbar spinal stenosis: current concept of management
    Ji-Won Kwon, Kyung-Soo Suk, Seong-Hwan Moon, Si-Young Park, Namhoo Kim, Sub-Ri Park, Jae-Won Shin, Hak-Sun Kim, Byung Ho Lee
    Asian Spine Journal.2026; 20(1): 143.     CrossRef
  • Delta large-channel endoscopy versus unilateral biportal endoscopy for cervicothoracic junction disc herniation: a prospective randomized controlled trial
    Huaibin Wang, Hui Li, Rushuo Wei, Hao Yan, Ruzhan Yao, Weiqiang Liu, Ling Li
    Journal of Orthopaedic Surgery and Research.2026;[Epub]     CrossRef
  • Intraoperative Dual-Cantilever Probe for Rapid Measurement of Cancellous Bone Compressive Strength Within the Vertebral Body
    Owen Kresse, Evelyn Khong, Gerhardus O. Loohuis, R. Elayne Shelby, Maxwell Boakye, Michael J. Voor, Stuart J. Williams
    Journal of Medical Devices.2026;[Epub]     CrossRef
  • Assisted full-endoscopic spine surgery for lumbar spinal stenosis: Technical note and learning curve
    Koichiro Ono, Daisuke Fukuhara, Yuka Yamami, Yushi Yamaguchi, Kazuma Miura, Yuki Kasuga, Kaichi Sato, Satoshi Takamoto, Naoya Takabayshi, Hiroshi Kawaguchi, Makoto Hirao
    Brain and Spine.2026; 6: 105935.     CrossRef
  • Thoracic Full-Endoscopic Decompression for Ossification of Ligamentum Flavum (OLF) Causing Myelopathy
    Rohit A. Thaker, Smit Kagathara, Pratik Shah
    Indian Spine Journal.2026; 9(1): 112.     CrossRef
  • Real-time Three-dimensional Navigation in Spine Surgery: Is It the Game Changer?
    Shailesh Hadgaonkar, Siddharth Aiyer, Abhinav Bhute, Parag Sancheti
    Indian Spine Journal.2026; 9(1): 37.     CrossRef
  • A retrospective Chinese study on optical–electromagnetic navigation-guided biportal endoscopic unilateral laminotomy for bilateral decompression in lumbar spinal stenosis: improving precision and efficiency
    Xingchen Yao, Junpeng Liu, Li Guan, Jincai Yang, Aixing Pan, Yong Hai
    Asian Spine Journal.2026;[Epub]     CrossRef
  • Robotic-Assisted Uniportal Full-Endoscopic Transforaminal Lumbar Interbody Fusion: A Technical Note on a Hybrid Form of Minimally Invasive Surgery
    Ting Yao Ang, A. Aravin Kumar, Chin Hong Ngai, John J.Y. Zhang, Jacob Y.L. Oh, Ji Min Ling, Thomas C.H. Tan
    Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(1): 105.     CrossRef
  • O‐Arm Navigation Enhances Facet Preservation Without Compromising Clinical Outcomes in UBE Decompression for Radiographically Stable Adult Degenerative Scoliosis: A Single‐Center Comparative Study
    Yi Liu, Yiwei Xie, Zhibao Chen, Ruijun Xu, Haojie Chen, Xiaojian Ye, Jiangming Yu
    Orthopaedic Surgery.2026; 18(6): 1203.     CrossRef
  • EndoUFM: Utilizing foundation models for monocular depth estimation of endoscopic images
    Xinning Yao, Bo Liu, Bojian Li, Jingjing Wang, Jinghua Yue, Fugen Zhou
    Neural Networks.2026; 203: 109141.     CrossRef
  • Transforaminal Endoscopic Lumbar Discectomy Versus Interlaminar Endoscopic Lumbar Discectomy for Lumbar Disc Herniation: A Systematic Review of Clinical Outcomes, Quality of Life, and Surgical Selection Strategies
    MOHAMMAD RIYAD ABDULWAHID AL-HASNAWI, Hadi Ali Hadi Dala Ali, Rasool Riyadh Abdulwahid Al Hasnawi, Ameer Neamah Saadoon Al-Mhemis, Hinal Alkeshkumar Patel, Oumaima Souilhi, Mustafa Faris Kadhim Kadhim, Mohammed ali modher abduljaleel
    Orthopedic Reviews.2026;[Epub]     CrossRef
  • Establishing navigated UBE in Europe – technical note
    Nicole Lange, Carolin Albrecht, Raimunde Liang, Luisa Mona Kraus, Ghaith Altawalbeh, Shadi Abulhala, Ann-Kathrin Joerger, Bernhard Meyer
    Brain and Spine.2026; 6: 106107.     CrossRef
  • Endoscopic‐Assisted Posterior Atlantoaxial Fusion: Technical Innovation and Clinical Experience
    Jichong Zhu, Chengqian Huang, Jiang Xue, Jiarui Chen, Yufan Xu, Dequan Liu, Xinli Zhan, Chong Liu
    Orthopaedic Surgery.2026; 18(8): 1768.     CrossRef
  • Research Progress on Percutaneous Endoscopic Treatment for Radicular Cervical Spondylosis
    怀忠 周
    Advances in Clinical Medicine.2026; 16(06): 2540.     CrossRef
  • Comparative Clinical and Radiological Outcomes of Arthroscopic‐Assisted Uniportal Spinal Surgery Versus Unilateral Biportal Endoscopy for Unilateral Laminotomy With Bilateral Decompression in Lumbar Spinal Stenosis: A 2‐Year Follow‐Up Study
    Abdul Waheed Bahir, Wang Daxing, Liu Bailian, Gan Xuewen, Xiong Ying, Xiao Jiayu, Gu Shao
    Orthopaedic Surgery.2026; 18(8): 1613.     CrossRef
  • Domain-Adapted Foundation Models for Single-Click Surgical Instrument Segmentation in Spinal Endoscopy
    Bong-Su Mun, Zhi Zhao, Sang-Min Park, Jiwon Park, Hyun-Jin Park, Hyung Rae Lee, Ho-Joong Kim, Jin S. Yeom
    Neurospine.2026; 23(3): 633.     CrossRef
  • A Structured Four-Phase Training Framework for Percutaneous Endoscopic Lumbar Discectomy: Literature Review and Survey-Based Pilot Study
    Bashar Altunbi, Bader Obeidat, Salim Al Abri, Oludare Ashaolu
    Asian Journal of Neurosurgery.2026;[Epub]     CrossRef
  • Application of the guidewire anchoring technique in lateral approach transforaminal endoscopic lumbar foraminoplasty: a propensity score–matched retrospective study
    Guoxing Ding, Huijing Shang, Fuhai Yan, Weijie Cui, Zhi Li, Yiheng Zhang, Zhan Wang, Yifan Feng, Junxiao Su, Hui Zhang
    Frontiers in Surgery.2026;[Epub]     CrossRef
  • Endoscopic Spine Surgery: Evidence Maturity and the Path Forward in the United States
    Matthew T. Kim, Seungjun Lee, Graham S. Goh, Don Y. Park, Samuel K. Cho, Jin-Sung Kim, Junseok Bae
    Journal of Bone and Joint Surgery.2026;[Epub]     CrossRef
  • Full-endoscopic extraforaminal lumbar discectomy: Use of 3-D image-guidance can mitigate risks and overcome steep learning curve
    Anwesha Dubey, Abhijith R. Bathini, Katherine Anastasi, Joshua Bakhsheshian
    Journal of Clinical Neuroscience.2025; 139: 111455.     CrossRef
  • Navigated Uniportal Endoscopic Decompression for Thoracic Myelopathy Secondary to Ossified Yellow Ligament: A Report of Two Cases
    Bing Wui Ng, Ozlan Izma Muhamed Kamil
    Cureus.2025;[Epub]     CrossRef
  • 13,007 View
  • 285 Download
  • 18 Web of Science
  • 21 Crossref

Technical Note

Robotic-Assisted Trans-Superior Articular Process Endoscopic Decompression: A Case Illustration and Technical Overview
Tamara Lee Ting Soh, Zachary Chu, Christoph P. Hofstetter, Jacob Yoong-Leong Oh
Neurospine 2025;22(1):128-133.   Published online March 31, 2025
DOI: https://doi.org/10.14245/ns.2449082.541

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

Include:

Robotic-Assisted Trans-Superior Articular Process Endoscopic Decompression: A Case Illustration and Technical Overview
Neurospine. 2025;22(1):128-133.   Published online March 31, 2025
DOI: https://doi.org/10.14245/ns.2449082.541
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
Format:
Include:
Robotic-Assisted Trans-Superior Articular Process Endoscopic Decompression: A Case Illustration and Technical Overview
Neurospine. 2025;22(1):128-133.   Published online March 31, 2025
DOI: https://doi.org/10.14245/ns.2449082.541
Close
The growth of minimally invasive techniques in spine surgery has accelerated in recent years, leading to development of new techniques and technology such as robotic-assisted spine surgery and full-endoscopic surgery. While robotic spine surgery offers the potential of increased precision and accuracy in instrumentation, endoscopic techniques are beneficial in reducing collateral tissue damage and allowing patients a faster return to function. We describe a case where we combine a robotic guidance system with a full-endoscopic technique, the trans-superior articular process decompression. We aim to share our experience as well as an overview of the surgical technique.

Citations

Citations to this article as recorded by  Crossref logo
  • Evaluating the Learning Curve and Surgical Efficacy in the Novel Robotic-Assisted Muscle-Preserving (RAMP) Spinal Decompression
    Giuseppe Loggia, Fedan Avrumova, Marco D. Burkhard, Michael J. Kelly, Franziska C. S. Altorfer, Maksym Polt, Jiaqi Zhu, Joseph L. Chazen, Ek T. Tan, Darren R. Lebl
    Global Spine Journal.2026; 16(5): 2162.     CrossRef
  • Global research trends in robot-assisted spinal surgery: a visualized bibliometric analysis
    Hailun Huang, Ziyu Lian, Yong’ai Liu, Kui Sun
    Journal of Robotic Surgery.2025;[Epub]     CrossRef
  • From complexity to clarity: A perspective on personalized spine care through genetic, psychosocial, and technological advancements
    Favour Tope Adebusoye, Rohan S. Mane, Liyana Nithya Paaramee Priyankara, Mohammed Ahmed, Shubham Gaikwad, Jovan Ilic, Yash J. Pal, Brandon Lucke-Wold, Julie L. Chan, Daniel J. Hoh, Matthew Decker, Steven G. Roth, Daryl Pinion Fields, Paul R. Krafft
    Journal of Craniovertebral Junction and Spine.2025; 16(4): 379.     CrossRef
  • 5,532 View
  • 138 Download
  • 3 Web of Science
  • 3 Crossref

Video Articles

Video Articles: Special Issue With JMISST

O-Arm Navigation-Guided Unilateral Biportal Endoscopic Decompression of Far-Out Syndrome
Rohit Akshay Kavishwar, YiHao Liang, Dongeon Lee, Jaehwan Kim, Maria Pedraza, Jin-Sung Kim
Neurospine 2024;21(4):1149-1153.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449140.570

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

Include:

O-Arm Navigation-Guided Unilateral Biportal Endoscopic Decompression of Far-Out Syndrome
Neurospine. 2024;21(4):1149-1153.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449140.570
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
Format:
Include:
O-Arm Navigation-Guided Unilateral Biportal Endoscopic Decompression of Far-Out Syndrome
Neurospine. 2024;21(4):1149-1153.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449140.570
Close
The main aim of this video article is to demonstrate the combined use of O-arm navigation and unilateral biportal endoscopy (UBE) to manage far-out syndrome (FOS). In FOS there is entrapment and compression of the fifth lumbar nerve beyond the foramen and between L5 transverse process and the sacral ala at the lumbosacral junction. Conventional microscopic decompression using a paraspinal approach had been the gold standard for its management. However, the surgery is technically challenging due to the deep location of the pathology and intricate anatomy of extraforaminal space. There have been some published reports of unsatisfactory outcomes with microscopic decompression for FOS. We decided to integrate navigation with UBE to increase precision for the management of FOS. A 70-year-old female presented to us with chief complaint of left lower limb radiculopathy since 1 year. She also complained of numbness and paresthesias in her left leg and foot. She was unable to walk for more than 10 minutes due to pain. Her magnetic resonance imaging scan revealed compression of left L5 nerve root in the extraforaminal region. UBE decompression via paraspinal approach was performed for her under O-arm navigation. She experienced immediate relief of her symptoms in the postoperative period. O-arm-navigation-guided UBE is an effective and safer alternative to microsurgical decompression for the management of FOS. This video demonstrates the step-by-step implementation of O-arm navigation with endoscopy and its precise execution.

Citations

Citations to this article as recorded by  Crossref logo
  • Arthroscopic-assisted uni-portal spinal surgery technology in the treatment of far-out syndrome: A case report and literature review
    Yuanmeng Chen, Heng Bi, Wei Zhang, Junyi Xiang, Benjing Yin, Chang Liu, Yu Lu
    Journal of International Medical Research.2026;[Epub]     CrossRef
  • O‐Arm Navigation Enhances Facet Preservation Without Compromising Clinical Outcomes in UBE Decompression for Radiographically Stable Adult Degenerative Scoliosis: A Single‐Center Comparative Study
    Yi Liu, Yiwei Xie, Zhibao Chen, Ruijun Xu, Haojie Chen, Xiaojian Ye, Jiangming Yu
    Orthopaedic Surgery.2026; 18(6): 1203.     CrossRef
  • Unilateral Biportal Endoscopic en Bloc Resection of the Lumbosacral Ligament Following Bony Release: A Technique Aiming to Reduce Dorsal Root Ganglion Manipulation
    Cheng-Ying Lee, Cheol-Wung Park, Man-Kyu Park, Wei-Yu Lee, Chien-Min Chen
    Journal of Clinical Medicine.2026; 15(10): 3765.     CrossRef
  • O-arm navigation-guided uni-portal non-coaxial spinal endoscopic surgery for the precise treatment of far-out syndrome—a case report and literature review
    Kai Lv, Dong Zhang, Xinhe Wang, Qiugen Wang, Zhichao Ge, En Song, Hao Sun, Mencheng Yin, Jiajun Wu, Shuqiang Wang, Jianmin Li
    Frontiers in Surgery.2026;[Epub]     CrossRef
  • Navigation-Assisted Unilateral Biportal Endoscopic Decompression of Far-Out Compression in Bertolotti Syndrome: A Technical Note
    Warayos Trathitephun, Jackapol Kamolpak, Rathapoom Suwanaratana, Siravich Suvithayasiri
    Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(Suppl 2): S391.     CrossRef
  • O-arm navigation-based transforaminal unilateral biportal endoscopic discectomy for upper lumbar disc herniation: an innovative preliminary study
    Dong Hyun Lee, Choon Keun Park, Jin-Sung Kim, Jin Sub Hwang, Jin Young Lee, Dong-Geun Lee, Jae-Won Jang, Jun Yong Kim, Yong-Eun Cho, Dong Chan Lee
    Asian Spine Journal.2025; 19(2): 194.     CrossRef
  • Full-endoscopic Spine Surgery for the Treatment of Far-out Syndrome: A Case Series
    Ryuichi WATANABE, Ryoji TOMINAGA, Kento TAKEBAYASHI, Yasushi OSHIMA, Hiroki IWAI, Hisashi KOGA
    Neurologia medico-chirurgica.2025; 65(12): 583.     CrossRef
  • 5,936 View
  • 193 Download
  • 9 Web of Science
  • 7 Crossref

Video Articles: Special Issue With JMISST

Paramedian Unilateral ‘Bitubular’ Endoscopic Access for a Far Lateral Disc Herniation: A Novel Approach for Far Lateral Lumbar Pathologies
Hui-Ling Kerr, Rohit Wadikhaye, Gyeong Ung Sun, Cheol Woong Park
Neurospine 2024;21(4):1160-1167.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449096.548

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

Include:

Paramedian Unilateral ‘Bitubular’ Endoscopic Access for a Far Lateral Disc Herniation: A Novel Approach for Far Lateral Lumbar Pathologies
Neurospine. 2024;21(4):1160-1167.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449096.548
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
Format:
Include:
Paramedian Unilateral ‘Bitubular’ Endoscopic Access for a Far Lateral Disc Herniation: A Novel Approach for Far Lateral Lumbar Pathologies
Neurospine. 2024;21(4):1160-1167.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449096.548
Close
We present a novel technique to approach far lateral lumbar pathologies using a bitubular, biportal endoscopic system and a paramedian approach. Background: Conventional approaches for lumbar far lateral discectomy range from open approaches to newer minimally invasive approaches such as tubular discectomy and single portal endoscopic discectomy. We present a case of a patient suffering with a left L3–4 and left L4–5 extraforaminal disc herniation who was treated successfully with a left sided bitubular, biportal endoscopic 2 level far lateral discectomy. A paramedian ‘bitubular’ biportal endoscopic approach is safe and effective for far lateral lumbar pathologies with excellent visualisation due to good outflow of irrigation fluid.

Citations

Citations to this article as recorded by  Crossref logo
  • A Fixed Left-Sided Surgeon Position in Unilateral Biportal Endoscopic Surgery for Lumbar Disc Herniation: A Technical Note with Variations According to Herniation Type
    Aurore Sellier, Francois Lechanoine, Guillaume Lonjon, Louis-Marie Terrier, François-Xavier Ferracci, Philippe Cam, Anthony Melot, Joseph Cristini
    World Neurosurgery.2026; 208: 124890.     CrossRef
  • Full-endoscopic trans-pars interarticularis discectomy for foraminal and extraforaminal lumbar disc herniation: surgical technique and early clinical outcomes
    Mohammad Badra, Georges Sakhat, Ahmad Haj Hussein, Ralph Maroun, Ramzi Moucharafieh, Karim Areslan, Youssef Jamaleddine
    Brain and Spine.2026; 6: 106058.     CrossRef
  • Far-Lateral Transforaminal Unilateral Biportal Endoscopic Lumbar Discectomy for Upper Lumbar Disc Herniations
    Jin Seop Hwang, Sang Hyub Lee, Dain Jeong, Jae-Won Jang, Yong Eun Cho, Dong-Geun Lee, Choon Keun Park, Chung Kee Chough
    Neurospine.2025; 22(1): 14.     CrossRef
  • 7,428 View
  • 122 Download
  • 3 Web of Science
  • 3 Crossref

Video Articles: Special Issue With JMISST

Endoscopic Transforaminal Thoracic Decompression for Removal of a Giant Calcified Thoracic Disc Herniation
Mazda Farshad, Christoph Johannes Laux, Lukas Zingg, Florian Wanivenhaus
Neurospine 2024;21(4):1116-1118.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449064.532

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

Include:

Endoscopic Transforaminal Thoracic Decompression for Removal of a Giant Calcified Thoracic Disc Herniation
Neurospine. 2024;21(4):1116-1118.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449064.532
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
Format:
Include:
Endoscopic Transforaminal Thoracic Decompression for Removal of a Giant Calcified Thoracic Disc Herniation
Neurospine. 2024;21(4):1116-1118.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449064.532
Close
To demonstrate the preoperative workup, surgical planning and execution of transforaminal endoscopic thoracic discectomy (TETD) for a giant calcified disc herniation. Surgeries for symptomatic thoracic disc herniations are rare and challenging. The main goal is to achieve sufficient decompression with minimal manipulation of the spinal cord. Conventional surgical techniques may have significant approach-related morbidities and often require additional stabilization. The full endoscopic transforaminal technique is the least invasive approach so far. A 73-year-old female patient with progressive gait disturbance and paraparesis received radiological imaging which revealed a giant calcified thoracic disc herniation at the level T11–12. The preoperative workup, planning and execution of TETD is demonstrated in detail. This report represents a typical educational case of a giant calcified thoracic disc herniation, treated by TETD.

Citations

Citations to this article as recorded by  Crossref logo
  • Treatment of Calcified Thoracic Disc Herniation by Percutaneous Spinal Endoscopy with Culvert Decompression
    Donglun Xiao, Yuefei Li, Ning Sun, Xin Liu, Rui Li, Tianwei Sun
    World Neurosurgery.2026; 206: 124763.     CrossRef
  • Anesthetic complications of extensive spinal nerve block and total spinal anesthesia during percutaneous endoscopic spinal surgery under local anesthesia
    Bao-Shan Xu, Shuai-Shuai Wei, Wen-Yi Li, Qiang Yang, Kai-Hui Zhang, Bing-Gang Guan, Chao Chen, Hai-Wei Xu, Ning Li, Li-Long Du, Tong-Xing Zhang, Jia-Wen Guan, Jia-Guo Zhao, Yue Zhou, Dong Ming
    European Spine Journal.2026;[Epub]     CrossRef
  • Calcified Thoracic Disc Herniation: Surgical Management, Surgical Approaches, and Decision-Making
    Stylianos Kapetanakis, Mikail Chatzivasiliadis, Benjamin Cappin, Paschalis Tsioulas, Lazaros Poultsides, Panagiotis Konstantinou, Christos Siopis, Iosafat Pinto, Konstantinos Ditsios
    Orthopedic Reviews.2026;[Epub]     CrossRef
  • 4,602 View
  • 114 Download
  • 4 Web of Science
  • 3 Crossref

Video Articles: Special Issue With JMISST

Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration
Warayos Trathitephun, Jackapol Kamolpak, Siravich Suvithayasiri
Neurospine 2024;21(4):1102-1105.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449054.527

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

Include:

Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration
Neurospine. 2024;21(4):1102-1105.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449054.527
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
Format:
Include:
Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration
Neurospine. 2024;21(4):1102-1105.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449054.527
Close
This surgical video demonstrates the full-endoscopic repair of an incidental durotomy, offering practical guidance and insights into the technique. Incidental dural tears occur in up to 1% of lumbar endoscopic surgeries, with risk factors including interlaminar approaches, stenosis decompression, and power drill usage. Although many dural tears are managed with sealant or gel foam, no standard exists for when surgical repair is necessary. Complications such as cerebrospinal fluid leakage, radiculopathy, and neurological deficits can arise, prompting the need for effective repair techniques. A 50-year-old man presented with bilateral leg claudication due to lumbar stenosis (L4–S1). Full-endoscopic decompression was performed, during which an incidental 10-mm dural tear occurred at L5–S1. The nerve root was repositioned into the dural sac, and the tear was repaired using a 6-0 prolene suture with a knot pusher under endoscopic guidance. Gelfoam was applied to aid compression, and irrigation pressure was reduced to prevent increased intracranial pressure. The patient was mobilized after 48 hours and experienced significant symptom improvement without neurological deficits. We propose that dural tears should be repaired when possible to prevent complications. Surgeon experience, tear size, and location are critical factors. This case demonstrates a simple, effective endoscopic repair method, though further studies are needed to establish its long-term efficacy.

Citations

Citations to this article as recorded by  Crossref logo
  • A large-scale database comparison of contemporary surgical complications in cervical radiculopathy: Cervical disc replacement versus posterior cervical foraminotomy
    Nicholas J. Cormas, Ariaz Goudarzi, Ved Vengsarkar, J. Allen Chi, Joyce Wang, Li Jin, Stephen Lockey, Xudong Joshua Li
    Journal of Orthopaedics.2026; 72: 262.     CrossRef
  • Full Endoscopic Excision of a Large Intradural Extramedullary Tumor: A Technical Note
    Kanthila Mahesha, H. Shatananda Prasad Rao
    Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(1): 124.     CrossRef
  • Percutaneous and Endovascular Treatment of Spontaneous Intracranial Hypotension and Related Cerebrospinal Fluid Disorders
    Jason Jarred Sims, Kevin John, Zachary Wilseck, Neeraj Chaudhary
    Seminars in Roentgenology.2026; 63: 151003.     CrossRef
  • Endoscope-Assisted Versus Conventional Posterior Fossa Decompression with Duraplasty for Chiari I Malformation: A Single-Center Comparative Study
    Mahmut Çamlar, Umut Tan Sevgi, Mustafa Eren Yüncü, Abdullah Bozoklar, Nevzat Semih Parlak, Çağlar Türk, Meryem Merve Ören Çelik, Ali Karadağ
    Medicina.2026; 62(7): 1285.     CrossRef
  • Dural Tears in Endoscopic Spine Surgery: Incidence, Risk Factors, Prevention, and Management
    Mark Kurapatti, Junho Song, Samuel K. Cho
    JBJS Reviews.2026;[Epub]     CrossRef
  • From the Editor-in-Chief: Featured Articles in the December 2024 Issue
    Inbo Han
    Neurospine.2024; 21(4): 1051.     CrossRef
  • A Commentary on “Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration”
    David Del Curto
    Neurospine.2024; 21(4): 1106.     CrossRef
  • 6,998 View
  • 208 Download
  • 6 Web of Science
  • 7 Crossref

Video Articles: Special Issue With JMISST

Transforaminal Endoscopic Lumbar Foraminotomy for Iatrogenic Foraminal Stenosis Following Vertebroplasty
Yong Ahn, Do-Yeon Rhee
Neurospine 2024;21(4):1137-1140.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449052.526

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

Include:

Transforaminal Endoscopic Lumbar Foraminotomy for Iatrogenic Foraminal Stenosis Following Vertebroplasty
Neurospine. 2024;21(4):1137-1140.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449052.526
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
Format:
Include:
Transforaminal Endoscopic Lumbar Foraminotomy for Iatrogenic Foraminal Stenosis Following Vertebroplasty
Neurospine. 2024;21(4):1137-1140.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449052.526
Close
We present a case of iatrogenic lumbar foraminal stenosis caused by bone-cement leakage during vertebroplasty, successfully managed using transforaminal endoscopic lumbar foraminotomy (TELF). Vertebroplasty is an effective treatment for osteoporotic vertebral compression fractures (VCFs); however, complications such as bone-cement leakage can lead to vascular or neurological issues, including lumbar radiculopathy. TELF is a minimally invasive surgical option for addressing various forms of lumbar foraminal stenosis. An 82-year-old female patient presented to Gachon University Gil Medical Center with severe right inguinal pain radiating to the anterior thigh and knee. Six months prior, she had undergone vertebroplasty at the L3 level for an osteoporotic VCF at another hospital. Following the procedure, she developed radicular leg pain with a diminished knee jerk reflex, which progressively worsened despite extensive conservative treatment. Magnetic resonance imaging and computed tomography revealed right-sided L3–4 foraminal stenosis caused by bone-cement leakage from the prior vertebroplasty. TELF was performed under local anesthesia to decompress the affected area. Bone-cement fragments, along with hypertrophic bone and ligaments, were successfully removed, achieving sufficient decompression of the exiting nerve root. The patient experienced immediate postoperative pain relief. This case represents the first documented instance of endoscopic decompression for iatrogenic foraminal stenosis following vertebroplasty. TELF, performed safely under local anesthesia, demonstrates its effectiveness as a minimally invasive solution for this rare complication.

Citations

Citations to this article as recorded by  Crossref logo
  • Cement leakage into adjacent vertebra during percutaneous vertebroplasty: “Gild the Lily” or “Kill two birds with one stone”?
    Rui-Feng Ji, De-an Qin
    International Journal of Surgery.2026; 112(6): 12975.     CrossRef
  • Current Evidence and Clinical Implications of Full-Endoscopic Spine Surgery for Post-Vertebroplasty Lumbar Radiculopathy: A Comprehensive Review
    Yong Ahn, Sol Lee, Chang Won Lee
    Journal of Pain Research.2026; Volume 19: 1.     CrossRef
  • O-arm navigation-based transforaminal unilateral biportal endoscopic discectomy for upper lumbar disc herniation: an innovative preliminary study
    Dong Hyun Lee, Choon Keun Park, Jin-Sung Kim, Jin Sub Hwang, Jin Young Lee, Dong-Geun Lee, Jae-Won Jang, Jun Yong Kim, Yong-Eun Cho, Dong Chan Lee
    Asian Spine Journal.2025; 19(2): 194.     CrossRef
  • Risk factors analysis of recurrent vertebral fractures after vertebroplasty
    Wei Wu, Kai Zhou, Bo Yang, Xianjin Luo
    Current Problems in Surgery.2025; 70: 101836.     CrossRef
  • 4,331 View
  • 86 Download
  • 3 Web of Science
  • 4 Crossref

Video Articles: Special Issue With JMISST

Hybrid Endoscopic Thoracic Discectomy Using Robotic Arm and Navigation for Highly Migrated Calcified Disc Herniation
Yi-Hao Liang, Rohit Akshay Kavishwar, Maria Pedraza, Dimas Rahman Setiawan, Jae-Hwan Kim, Jin-Sung Kim
Neurospine 2024;21(4):1126-1130.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449024.512

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

Include:

Hybrid Endoscopic Thoracic Discectomy Using Robotic Arm and Navigation for Highly Migrated Calcified Disc Herniation
Neurospine. 2024;21(4):1126-1130.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449024.512
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
Format:
Include:
Hybrid Endoscopic Thoracic Discectomy Using Robotic Arm and Navigation for Highly Migrated Calcified Disc Herniation
Neurospine. 2024;21(4):1126-1130.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2449024.512
Close
This video provides a step-by-step guide for performing the hybrid endoscopic thoracic discectomy using navigation and robotic arm for addressing high migrated calcified disc herniation. With the development of techniques, endoscopic spine surgery has emerged as a reliable treatment for thoracic myelopathy. This approach offers high-resolution, off-axis visualization of the surgical field. The field is poised to advance further as endoscopic instruments are refined, becoming less invasive and more precise through the integration of navigation and robot-assisted systems. A 62-year-old woman presented to us with chief complaints of both legs weakness. She had difficulty standing and walking after squatted due to weakness in her legs and her Oswestry Disability Index score was 66. On examination her both side knee extension and ankle dorsiflexion were grade 4 without dysesthesia. The imaging examination confirmed the diagnosis of thoracic myelopathy caused by a highly migrated calcified disc herniation at T5–6 level. The patient underwent an endoscopic thoracic discectomy using robotic arm and navigation for addressing highly migrated calcified disc herniation, resulting in an excellent outcome. The continuous development of navigation and robotic systems in endoscopic thoracic surgery enhanced accuracy in surgical incisions and instrument placement, as well as improved efficiency in locating pathology and achieving precise decompression. Endoscopic thoracic discectomy combines full-endoscopy and unilateral biportal endoscopic (UBE) techniques to leverage the benefits of both approaches, including the cross-viewing of full-endoscopy cannula and the use of larger Kerrison rongeurs under UBE.

Citations

Citations to this article as recorded by  Crossref logo
  • Multiple imaging-assisted Unilateral biportal endoscopy (UBE) for syringomyelia secondary to T11-12 ligamentum flavum ossification: A case report
    Yue Tian, Hao Li, Fuming Tian, Hongen Bao
    Asian Journal of Surgery.2026; 49(7): 4153.     CrossRef
  • A Commentary on “International Practice Patterns in the Surgical Management of Primary Lumbar Disc Herniation: An AO Spine Cross-Sectional Study”
    Jin-Sung Kim
    Neurospine.2026; 23(1): 40.     CrossRef
  • A preliminary descriptive study on the histology of giant calcified disc herniations: a case series
    Riccardo Cecchinato, Alessandra Colombini, Barbara Rubino, Daniele Vanni, Luca Maria Sconfienza, Pedro Berjano
    European Spine Journal.2026;[Epub]     CrossRef
  • O-arm navigation-based transforaminal unilateral biportal endoscopic discectomy for upper lumbar disc herniation: an innovative preliminary study
    Dong Hyun Lee, Choon Keun Park, Jin-Sung Kim, Jin Sub Hwang, Jin Young Lee, Dong-Geun Lee, Jae-Won Jang, Jun Yong Kim, Yong-Eun Cho, Dong Chan Lee
    Asian Spine Journal.2025; 19(2): 194.     CrossRef
  • Bilateral–Contralateral Endoscopic Decompression as a Fusion-Deferral Strategy in Upper Lumbar Stenosis: A Structural Rationale and Conditional Framework—A Technical Note with Cases Review
    Dong Hyun Lee, Sang Yeop Han, Seung Young Jeong, Il-Tae Jang
    Journal of Clinical Medicine.2025; 14(16): 5726.     CrossRef
  • 5,720 View
  • 138 Download
  • 5 Web of Science
  • 5 Crossref

Original Article

Minimally Invasive Spine Surgery

Comparative Outcomes of Biportal Endoscopic Decompression, Conventional Subtotal Laminectomy, and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Central Stenosis
Mu Ha Lee, Hyun Jun Jang, Bong Ju Moon, Kyung Hyun Kim, Dong Kyu Chin, Keun Su Kim, Jeong-Yoon Park
Neurospine 2024;21(4):1178-1189.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2448830.415

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

Include:

Comparative Outcomes of Biportal Endoscopic Decompression, Conventional Subtotal Laminectomy, and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Central Stenosis
Neurospine. 2024;21(4):1178-1189.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2448830.415
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
Format:
Include:
Comparative Outcomes of Biportal Endoscopic Decompression, Conventional Subtotal Laminectomy, and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Central Stenosis
Neurospine. 2024;21(4):1178-1189.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2448830.415
Close
Objective
Spinal stenosis is a prevalent condition; however, the optimal surgical treatment for central lumbar stenosis remains controversial. This study compared the clinical outcomes and radiological parameters of 3 surgical methods: unilateral laminectomy bilateral decompression with unilateral biportal endoscopy (ULBD-UBE), conventional subtotal laminectomy (STL), and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).
Methods
This retrospective study included 86 patients, divided into ULBD-UBE (n=34), STL (n=24), and MIS-TLIF (n=28) groups. We evaluated demographics and perioperative factors and assessed clinical outcomes using the visual analogue scale (VAS), Oswestry Disability Index (ODI), and neurogenic intermittent claudication (NIC). Radiological parameters assessed included lumbar lordosis, L4S1 Cobb angle (L4S1), T12S1 Cobb angle (T12S1), increased cross-sectional dural area (CSA), dynamic angulation (DA), dynamic slip (DS), and development of postoperative instability.
Results
The ULBD-UBE group showed a significantly shorter hospital stay duration and operation time and reduced blood loss than the other groups (p<0.001). ULBD-UBE group showed a trend towards greater VAS and ODI improvement at 1 month and postoperative NIC symptom relief. Radiologically, MIS-TLIF group exhibited lower postoperative DA and DS (p<0.001), indicating higher postoperative stability. Postoperative instability was lower in the ULBD-UBE group (2.9%) than in the STL group (16.7%) and similar to the MIS-TLIF group (0.0%) (p=0.028). The CSA was highest in the MIS-TLIF group (295.5%) compared to that in the other groups (ULBD-UBE, 216.3%; STL, 245.2%) (p<0.001).
Conclusion
Compared to other procedures, ULBD-UBE is a safe, effective, and viable surgical procedure for treating lumbar central stenosis.

Citations

Citations to this article as recorded by  Crossref logo
  • Bilateral versus Unilateral Decompression in Single-Level Transforaminal Lumbar Interbody Fusion for Degenerative Spondylolisthesis: A Retrospective Comparative Study
    Lu-ming Nong, Jian-jian Yin, Gong-ming Gao, Nan-wei Xu, Gong-yin Zhao, Yu-qing Jiang, Long Han
    World Neurosurgery.2026; 206: 124784.     CrossRef
  • Comparison of paraspinal muscle changes after biportal endoscopic and microscopic lumbar discectomy or decompression
    Ki-Han You, Sang-Min Park, Daniel Park, Min-Seok Kang, Seung-Yeon Jeong, Sun-Ho Cha, Samuel Cho, Hyun-Jin Park
    European Spine Journal.2026; 35(10): 6071.     CrossRef
  • O‐Arm Navigation Enhances Facet Preservation Without Compromising Clinical Outcomes in UBE Decompression for Radiographically Stable Adult Degenerative Scoliosis: A Single‐Center Comparative Study
    Yi Liu, Yiwei Xie, Zhibao Chen, Ruijun Xu, Haojie Chen, Xiaojian Ye, Jiangming Yu
    Orthopaedic Surgery.2026; 18(6): 1203.     CrossRef
  • A minimally invasive robotic spinal surgical system for anterior lumbar nerve decompression
    Qingxiang Zhao, Xiandi Wang, Xin Zhong, Runfeng Zhu, Peizhi Zhou, Dan Pu, Baitao Lin, Tao Li, Shiyuan Sui, Haonan Zhou, Yuxi Cheng, Hao Zheng, Henry K. Chu, Jiancheng Zeng, Kang Li
    Science Robotics.2026;[Epub]     CrossRef
  • The impact of body mass index on early readmission and reoperation following endoscopic vs. open/microsurgical lumbar surgery: A nationwide analysis
    Abdul Karim Ghaith, Yazan Alasadi, Xinlan Yang, Mohamad Ghaith, Melanie Alfonzo Horowitz, Husni Alasadi, Meghana Bhimreddy, Arjun K. Menta, Joshua Weinberg, Antony Fuleihan, Daniel Lubelski, Nicholas Theodore
    Clinical Neurology and Neurosurgery.2026; 269: 109553.     CrossRef
  • Cost-effectiveness analysis of the early transition from microscopic to biportal endoscopic unilateral laminectomy bilateral decompression
    Sung-Eun Kwon, Hangeul Park, Noah Hong, Woojin Kim, Jungbo Sim, Ho Sung Myeong, Seunghoon Lee, Jun-Hoe Kim, Chang-Hyun Lee, Fon-Yih Tsuang, Chi Heon Kim
    Medicine.2026; 105(34): e50400.     CrossRef
  • Totally endoscopic trans‑superior articular process lumbar interbody fusion: A case series on the development and preliminary evaluation of an innovative minimally invasive lumbar spine surgical technique
    Hualv Liu, Junjie Li, Yuhao Gao, Shilei Qin, Pengfei Han, Yunfeng Xu
    Experimental and Therapeutic Medicine.2025; 30(1): 1.     CrossRef
  • Bilateral–Contralateral Endoscopic Decompression as a Fusion-Deferral Strategy in Upper Lumbar Stenosis: A Structural Rationale and Conditional Framework—A Technical Note with Cases Review
    Dong Hyun Lee, Sang Yeop Han, Seung Young Jeong, Il-Tae Jang
    Journal of Clinical Medicine.2025; 14(16): 5726.     CrossRef
  • Reply Letter: A Commentary on “Comparative Outcomes of Biportal Endoscopic Decompression, Conventional Subtotal Laminectomy, and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Central Stenosis”
    Jeong-Yoon Park
    Neurospine.2025; 22(3): 875.     CrossRef
  • Efficacy of unilateral biportal endoscopy vs. unilateral portal endoscopy for the treatment of lumbar spinal stenosis: a systematic review and meta-analysis
    Yongjia Yu, Yuguang An, Chang Liu, Kemin Wang, Wuqiao Liang, Huazhong Gan, Zhaoju Hong, Qingmei Zhang, Maolin He, Daqin Feng
    Frontiers in Surgery.2025;[Epub]     CrossRef
  • A Commentary on “Comparative Outcomes of Biportal Endoscopic Decompression, Conventional Subtotal Laminectomy, and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Central Stenosis”
    Xiangge Liu
    Neurospine.2025; 22(3): 873.     CrossRef
  • Comparison of unilateral biportal endoscopic lumbar fusion and modified minimally invasive tubular lumbar fusion for lumbar disc herniation: a two-year retrospective study
    Jialong Qi, Mingxiang Liu, Tao Shan, Zhou Dong, Guosong Han, Zhihao Ni, Ke Zheng, Li Ma, Zhidong Zhang
    Frontiers in Neurology.2025;[Epub]     CrossRef
  • 9,674 View
  • 190 Download
  • 13 Web of Science
  • 12 Crossref

Video Article

Video Articles: Special Issue With JMISST

Full-Endoscopic Anterior Cervical Decompression and Fusion for Cervical Myelopathy
Christian Morgenstern
Neurospine 2024;21(4):1119-1125.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2448796.398

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

Include:

Full-Endoscopic Anterior Cervical Decompression and Fusion for Cervical Myelopathy
Neurospine. 2024;21(4):1119-1125.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2448796.398
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
Format:
Include:
Full-Endoscopic Anterior Cervical Decompression and Fusion for Cervical Myelopathy
Neurospine. 2024;21(4):1119-1125.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2448796.398
Close
This article aims to introduce a novel full-endoscopic anterior cervical discectomy and fusion (ACDF) procedure to treat cervical myelopathy. Adoption of endoscopic anterior cervical procedures has been lagging due to safety concerns and the necessity of placing an interbody cage. We have developed novel instrumentation and a modified percutaneous anterior cervical approach that allows a safe and reproducible full-endoscopic ACDF. Specially designed retractor blades facilitate percutaneous placement of a zero-profile cervical interbody cage. A 64-year-old male patient presents with chronic neck pain and bilateral paresthesia in his upper extremities, mild ataxia, and positive Hoffmann sign. He has a history of deep vein thrombosis 5 years prior. Preoperative magnetic resonance imaging and computed tomography scans show a degenerated disk, severe central canal stenosis with cord compression and a hyperintense cord signal at C5–6, compatible with cervical myelopathy. An electromyography of upper extrimities shows suspicion of myelopathy at C5–6. Full-endoscopic ACDF was performed at C5–6 to decompress the canal and restore disk height with a zero-profile interbody cage. Postoperatively the patient showed improvement of his symptoms with reduced pain and disability scores and was discharged from the hospital within 24 hours of the surgery. Outcome is satisfactory at 2-year postoperative follow-up. Full-endoscopic ACDF enables excellent visualization of the posterior endplates and cervical canal with constant irrigation, facilitating treatment of cervical myelopathy. No retraction is required during discectomy and decompression, decreasing the risk of postoperative dysphagia, hoarseness and bleeding. A zero-profile interbody cage can be percutaneously placed with special retractor blades.

Citations

Citations to this article as recorded by  Crossref logo
  • Technical evolution and short-term outcomes of minimally invasive versus conventional open anterior cervical discectomy and fusion: a systematic review and meta-analysis
    Zihua Ding, Jichen Liu, Haishan Xu, Yang Liu, Shaowei Xu, Zhen Wang
    Journal of Orthopaedic Surgery and Research.2026;[Epub]     CrossRef
  • Uniportal and Biportal Endoscopy for Cervical Spine Pathology
    Sehajvir Singh, Aditya S. Mazmudar, Alexander S. Kuczmarski, Jonathan A. Gabor, Daniel Park
    Contemporary Spine Surgery.2026; 27(9): 1.     CrossRef
  • Recent progress in surgical treatment of cervical spine myelopathy – A narrative review
    Jun Ouchida, Hiroaki Nakashima, Sadayuki Ito, Naoki Segi, Ippei Yamauchi, Shiro Imagama
    Journal of Clinical Orthopaedics and Trauma.2025; 68: 103074.     CrossRef
  • 7,911 View
  • 231 Download
  • 1 Web of Science
  • 3 Crossref
First First Prev Prev
Page of 4
Next Next Last Last
NS : Neurospine
Facebook Twitter