Many types of surgeries are changing from conventional to minimally invasive techniques. Techniques in spine surgery have also changed, with endoscopic spine surgery (ESS) becoming a major surgical technique. Although ESS has advantages such as less soft tissue dissection and normal structure damage, reduced blood loss, less epidural scarring, reduced hospital stay, and earlier functional recovery, it is not possible to replace all spine surgery techniques with ESS. ESS was first used for discectomy in the lumbar spine, but the range of ESS has expanded to cover the entire spine, including the cervical and thoracic spine. With improvements in ESS instruments (optics, endoscope, endoscopic drill and shaver, irrigation pump, and multiportal endoscopic), limitations of ESS have gradually decreased, and it is possible to apply ESS to more spine pathologies. ESS currently incorporates new technologies, such as navigation, augmented and virtual reality, robotics, and 3-dimentional and ultraresolution visualization, to innovate and improve outcomes. In this article, we review the history and current status of ESS, and discuss future goals and possibilities for ESS through comparisons with conventional surgical techniques.
Citations
Citations to this article as recorded by
Adoption of Endoscopic Spine Surgery Rohan Vemu, Mohammed S. Abdullah, Sachin Gupta, David Casper, Amrit Khalsa, Bijan Dehghani Clinical Spine Surgery.2026; 39(3): E148. CrossRef
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
Effect of Intraoperative Image-Guided Spinal Navigation Technologies on Endoscopic Lumbar Spine Surgery: A Systematic Review and Meta-Analysis Yu-Che Wang, Hsu-I Chou, Ying-Fong Su, Rafael Garcia de Oliveira, Abhinav K. Sharma, Yang-Ching Chen, Anh Tuan Bui, Ching-Yu Lee, Jowy Tani, Cheng-Chun Chang, Takaki Yoshimizu, Wongthawat Liawrungrueang, Tsung-Jen Huang, Daisuke Sakai, Klaus John Schnake, Global Spine Journal.2026; 16(2): 1268. 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
Clinical Outcomes and Future Directions of Endoscopic Cervical Spine Surgery: A Systematic Review With Narrative Insights Ryan Wang, Satheeshram Tamilselvan, Ji Soo Ha, Aditya Vedantam, Courtney Rory Goodwin, Nathan Evaniew, Uzondu F. Agochukwu, Konstantinos Margetis, Yoon Ha, Michael Fehlings, Jefferson R. Wilson, Ankit I. Mehta Global Spine Journal.2026;[Epub] CrossRef
Impact of arthroscopic experience on the learning curve in interlaminar endoscopic lumbar discectomy: a single-center prospective cohort study of 240 patients Tomasz Sienkiel, Marcin Gąska, Przemysław Koszyk, Ewa Lipik, Barbara Jasiewicz European Spine Journal.2026;[Epub] CrossRef
Anatomical Validation and Technical Feasibility of Biportal Endoscopic Spinal Surgery Including Technical Notes in a Cadaveric Canine Thoracic Intervertebral Disc Disease Model Sung-Ho Lee, Ji-Hyun Park, Da-Eun Kim, Gunha Hwang, Chang-Hwan Moon, Dongbin Lee Animals.2026; 16(3): 435. CrossRef
The Initial Learning and Supply Cost Curve of Incorporating Interlaminar and Transforaminal Endoscopy at a Tertiary Academic Medical Center Mark M Zaki, Edward S Harake, Varun G Kathawate, Michael J Strong, Rushikesh S Joshi, Joseph R Linzey, Yamaan S Saadeh, Osama N Kashlan Cureus.2026;[Epub] CrossRef
Efficacy and safety of unilateral biportal endoscopy vs. percutaneous endoscopic interlaminar approach in lumbar disc herniation: A meta‑analysis Yuhao Gao, Fangzheng He, Ji Wen, Shilei Qin, Pengfei Han, Yunfeng Xu Experimental and Therapeutic Medicine.2026; 31(3): 1. CrossRef
Development of a Deep-Learning Model for Automated Detection and Quantification of Bleeding in Unilateral Biportal Endoscopic Spine Surgery Takaki Yoshimizu, Daisuke Sakai, Daiki Morita, Meng-Huang Wu, Teruaki Miyake, Sanshiro Saito, Tetsutaro Mizuno, Ushio Nosaka, Keisuke Ishii, Mizuki Watanabe, Kanji Sasaki Journal of Clinical Medicine.2026; 15(5): 1934. CrossRef
Unilateral biportal endoscopic partial cervical laminectomy and facetectomy: An ex vivo study and case report Hojung Bae, Haebeom Lee, Sanghyun Nam, Youngjin Jeon, Jaemin Jeong Veterinary Surgery.2026; 55(3): 657. CrossRef
Endoscopic Spine Surgery: A Scoping Review of the Literature Drew Mulhall, Chien Yew Kow, Catherine Veilleux, Anand Oliveira Masson, Steven Casha, Stephan du Plessis, Ken Thomas, Michael M. H. Yang Global Spine Journal.2026;[Epub] CrossRef
Simulation training in spinal endoscopic surgery: a systematic review of current status Gilberto Perez Rodriguez Garcia, Abdulwhab Alotaibi, Omid Yousefi, Ataollah Shahbandi, Pegah Ghamasaee, Abdul Mounnem Yassin Kassab, Rakan Bokhari, Muhammad Abd-El-Barr, Saman Shabani, Mohamad Bakhaidar Neurosurgical Review.2026;[Epub] CrossRef
DIFFERENCES IN PREOPERATIVE RADIOGRAPHIC PARAMETERS OF THE LUMBOSACRAL SEGMENT AND PELVIS IN THE CASE OF TRANSFORAMINAL AND INTERLAMINAR DISCECTOMY OF L5-S1 INTERVERTEBRAL DISC HERNIATION V. К. Piontkovskyi, М. B. Holbaum Bulletin of Problems Biology and Medicine.2026; 1(1): 318. CrossRef
Uniportal Endoscopic Surgery for Thoracolumbar Junction Disc Herniation in a Patient With Myelopathy: A Technical Note and Surgical Video Kang Suk Moon, Michel Gustavo Mondragón-Soto, Pedro Leonardo Villanueva-Solórzano Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(1): 155. CrossRef
Biportal Endoscopic Spine Surgery for Epidural Metastatic Tumors: A Surgical Technical Note With a Case Series Chan Yang Noh, Il Choi, Junsoo Jang Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(1): 140. CrossRef
Biportal Endoscopic Foramen Magnum Decompression in an Arnold-Chiari Malformation: A Technical Note With a Case Report Chan Yang Noh, Il Choi, Junsoo Jang Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(1): 137. CrossRef
Full-Endoscopic Sacroiliac Joint Denervation for Painful Sacroiliac Joint Dysfunction: A Prospective 2-Year Clinical Outcomes and Predictors for Improved Outcomes Saqib Hasan, Dia Radi Halalmeh, Yusuf-Zain Ansari, Amy Herrera, Christoph P. Hofstetter Neurosurgery.2025; 96(1): 213. CrossRef
Research topics and trends of isthmic spondylolisthesis: A bibliometric analysis and review of Literature Mellisa Gani, Rieva Ermawan, Nanang Wiyono, Rhyan Darma Saputra, Hubertus Corrigan Journal of Orthopaedic Reports.2025; 4(3): 100457. CrossRef
Attitudes regarding barriers to entry and the learning curve associated with endoscopic decompression-only surgery: an international survey Murad Alostaz, Peter Derman, Patricia Lipson, Jerry Du, Raymond Gardocki, Christoph Hofstetter, Michael Wang, Sheeraz Qureshi, Philip K. Louie The Spine Journal.2025; 25(5): 983. CrossRef
What is the learning curve for endoscopic spine surgery? A comprehensive systematic review Justin P. Chan, Thomas Olson, Beshoy Gabriel, Sohaib Hashmi, Hao-Hua Wu, Hansen Bow, Yu-Po Lee, Nitin Bhatia, Michael Oh, Don Y Park The Spine Journal.2025;[Epub] CrossRef
Cost-effectiveness analysis of extended endoscopic lumbar foraminotomy (EELF) and transforaminal lumbar interbody fusion (TLIF): a prospective observational study Jun-Hoe Kim, Hangeul Park, Chang-Hyun Lee, Chi Heon Kim Scientific Reports.2025;[Epub] CrossRef
Clinical efficacy and learning curve of percutaneous endoscopic cervical discectomy for symptomatic cervical spondylotic radiculopathy Xiao Sun, Lijuan Zhan, Zhongxin Tang, Mingkui Shen, Haijun Ma, Jun Tan Journal of Orthopaedic Surgery and Research.2025;[Epub] CrossRef
Endoscopic Approach for Low Back Pain and Foraminal Pathologies Jeong-Yoon Park, Koichi Sairyo, Yukoh Ohara, Keng Chang Liu Journal of Minimally Invasive Spine Surgery and Technique.2025; 10(Suppl 1): S34. CrossRef
Strategies for Optimizing Clinical Outcomes in Minimally Invasive Spine Surgery Chibuikem A. Ikwuegbuenyi, Sean Inzerillo, Evan Wang, Ibrahim Hussain Neurosurgery.2025; 96(3S): S139. CrossRef
A novel endoscopic posterior cervical decompression and interbody fusion technique: Feasibility and biomechanical analysis Guangnan Yang, Yiwei Ding, Jiang Liu, Rigbat Rozi, Zhili Ding, Tusheng Li, Qiang Jiang, Hanshuo Zhang, Jingbo Ma, Jiaheng Han, Yu Ding Computer Methods and Programs in Biomedicine.2025; 262: 108676. CrossRef
Unusual Cause of Spinal Stenosis Related to Lumbar Ossification of Posterior Longitudinal Ligament: A Case Report and Literature Review Lu-Wei Huang, Hsin-Chang Chen, Yueh-Hsiu Lu, Chiu-Liang Chen, Yi-An Li Formosan Journal of Musculoskeletal Disorders.2025; 16(1): 38. CrossRef
Full-endoscopic lumbar spine discectomy: Are We Finally There? A Meta-Analysis of Its Effectiveness Against Non-microscopic Discectomy, Microdiscectomy and Tubular Discectomy Kajetan Latka, Klaudia Kozlowska, Kacper Domisiewicz, Tomasz Klepinowski, Dariusz Latka The Spine Journal.2025;[Epub] CrossRef
Electromagnetic Navigation in Biportal Endoscopic Lumbar Spine Surgery Dhivakaran Gengatharan, Walter Soon Yaw Wong, Lee Kai Lin, John Wen Cong Thng, Huang Yilun Spine Surgery and Related Research.2025; 9(2): 258. CrossRef
Transforaminal Endoscopic Thoracic Discectomy Is More Cost-Effective Than Microdiscectomy for Symptomatic Disc Herniations Junseok Bae, Pratyush Shahi, Sang-Ho Lee, Han-Joong Keum, Ju-Wan Seok, Yong-Soo Choi, Jin-Sung Kim Neurospine.2025; 22(1): 118. CrossRef
Clinical Outcomes and Patient Perspectives in Full Endoscopic Cervical Surgery: A Systematic Review Wongthawat Liawrungrueang, Sung Tan Cho, Ayush Sharma, Watcharaporn Cholamjiak, Meng-Huang Wu, Lo Cho Yau, Hyun-Jin Park, Ho-Jin Lee Neurospine.2025; 22(1): 81. CrossRef
Biportal Endoscopic Spine Surgery for Symptomatic Postoperative Discal Pseudocyst Following Percutaneous Endoscopic Interlaminar Discectomy: A Case Report and Literature Review Tran Vu Hoang Duong, Pham Anh Tuan, Huynh Van Vu, Chu Van Lam, Le Tan Linh Journal of Minimally Invasive Spine Surgery and Technique.2025; 10(1): 152. 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
Effectiveness of biportal endoscopic lumbar interbody fusion using the multi-layer bone grafting technique: a retrospective study from Vietnam Tran Vu Hoang Duong, Pham Anh Tuan, Huynh Van Vu, Chu Van Lam, Le Tan Linh, Phan Duy, Wongthawat Liawrungrueang Asian Spine Journal.2025; 19(2): 228. CrossRef
Advancements in Spinal Endoscopic Surgery: Comprehensive Techniques and Pathologies Addressed by Full Endoscopy Beyond Lumbar Disc Herniation Jad El Choueiri, Francesca Pellicanò, Edoardo Caimi, Francesco Laurelli, Leonardo Di Cosmo, Ali Darwiche Rada, Daniel Cernigoi, Arosh S. Perera Molligoda Arachchige, Giorgio Cracchiolo, Donato Creatura, Ali Baram, Carlo Brembilla, Gabriele Capo Journal of Clinical Medicine.2025; 14(11): 3685. CrossRef
Endoscopic Interlaminar Standalone Decompression for Lumbar Lateral Recess Stenosis With Subligamentous Disc Herniation: A Disc‐Preserving Alternative to Discectomy Kuan‐Ting Chen, Tsung‐Mu Wu, Chung‐Han Ho, Chi‐Ming Huang, Kin Weng Wong Orthopaedic Surgery.2025; 17(7): 2093. CrossRef
Full-Endoscopic Spine Surgery : Its Roles and Limitations Yong Ahn Journal of Korean Neurosurgical Society.2025; 68(5): 511. CrossRef
Endoscopic Decompression Combined With Percutaneous Pedicle Screw Fixation for AOSpine A3 or A4 Thoracolumbar Fractures With Neurological Deficits: A Retrospective Cohort Study Huiming Yang, Junxian Miao, Jiangtao Wang, Dan Han, Yuhang Wang, Liang Yan, Biao Wang, Dingjun Hao Neurospine.2025; 22(2): 571. CrossRef
Advances in endoscopic lumbar spine surgery: a comprehensive review of the techniques used for the treatment of lumbar disc herniations and spinal stenosis and lumbar spinal fusion Brian Kwon, Andrew Moon The Spine Journal.2025;[Epub] CrossRef
Decompression Only by Unilateral Biportal Endoscopic Surgery for Adjacent Segment Degeneration: A Multi-Institution Retrospective Study Dongkyu Kim, Jung Hwan Lee, Chung Kee Chough, Kwan-Su Song, Ohyuk Kwon, Jeong-Yoon Park Journal of Minimally Invasive Spine Surgery and Technique.2025; 10(Suppl 2): S245. CrossRef
Evaluation of the performance of large language models in endoscopic lumbar surgery: a comparative analysis Hao Li, Cheng Zeng, Lei Miao, Ye Wang, Jiyuan Xia, Da He Annals of Medicine & Surgery.2025; 87(8): 4835. CrossRef
Adaptation study for biportal endoscopic spine surgery using an ovine spine-based training model Hüseyin Doğu, Ali Osman Muçuoğlu Journal of Health Sciences and Medicine.2025; 8(4): 716. 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
Biportal endoscopic versus conventional open spine surgery for lumbar degenerative disease: a systematic review and meta‑analysis Alexander Yu, Mark Kurapatti, Ryan Hoang, Charu Jain, Gray William Ricca, Junho Song, Joshua Lee, Daniel Berman, Samuel Kang-Wook Cho Asian Spine Journal.2025; 19(5): 809. CrossRef
Biportal endoscopic spine surgery for removal of pedicle fixation hardware Ralph J. Mobbs, Alison Ma Journal of Clinical Neuroscience.2025; 141: 111580. CrossRef
Spine endoscopic surgery establishment for disc disease (Neurocore-SENSED): an open and decentralized consensus Mejdeddine Al Barajraji, Sami Barrit, Adam Boukind, Albert E. Telfeian, Javier Quillo-Olvera, Mehdi Afathi, Frank Hassel, Peter B. Derman, Maxime Challali, Alexandre Simonin, Antoine Devalckeneer, Ryoji Tominaga, Jean-Charles Le Huec, Xavier A. Santander, Brain and Spine.2025; 5: 105604. CrossRef
Endoscopic Decompression of Periradicular Fibrous Tissue in Lumbar Canal Stenosis: A Case Report Guna Pratheep Kalanchiam, Pang Hung Wu Journal of Minimally Invasive Spine Surgery and Technique.2025; 10(2): 238. CrossRef
Targeted Navigation-Guided Biportal Endoscopy for Thoracic Myelopathy Due to Disk-Osteophyte Shailesh Hadgaonkar, Sameer Nagpal, Parag Sancheti JBJS Case Connector.2025;[Epub] CrossRef
Integration of Virtual Reality Headsets into Endoscopic Spine Surgery: Insights from a Cadaveric Lab and Multicenter Surgeon Survey Bernardo Drummond Braga, Mateus Neves Faria Fernandes, Ana Paula Carvalho Fortaleza, Diego da Silva Collares, Edgar Takao Utino, João Paulo Bergamaschi Spine Surgery and Related Research.2025; 9(6): 609. CrossRef
Biportal Endoscopic Lumbar Interbody Fusion Using the Oblique Lumbar Interbody Fusion Cage: Technical Note and Case Illustration Tran Vu Hoang Duong, Phan Quang Son, Le Tan Bao, Luc Dinh Phuong, Phan Dinh Thanh Journal of Minimally Invasive Spine Surgery and Technique.2025; 10(2): 303. CrossRef
Preoperative planning combining 3D reconstruction and body-surface meshing for percutaneous endoscopic lumbar discectomy in far lateral lumbar disk herniation Liang Jiao, Shuang Wang, Xiao Yang, Jun-xiong Ma, Liang Zheng, Hong Wang, Liang-bi Xiang, Hai-long Yu, Yu Chen Minimally Invasive Therapy & Allied Technologies.2025; : 1. CrossRef
The Evolution of Spinal Endoscopy: Design and Image Analysis of a Single-Use Digital Endoscope Versus Traditional Optic Endoscope Shih-Hao Cheng, Yen-Tsung Lin, Hsin-Tzu Lu, Yu-Chuan Tsuei, William Chu, Woei-Chyn Chu Bioengineering.2024; 11(1): 99. CrossRef
Exoscope Use in Spine Surgery: A Systematic Review of Applications, Benefits, and Limitations Vikas N. Vattipally, Kelly Jiang, Carly Weber-Levine, Richard Rosin, A. Daniel Davidar, Andrew M. Hersh, Jawad Khalifeh, A. Karim Ahmed, Tej D. Azad, Kimberly Ashayeri, Daniel Lubelski, Debraj Mukherjee, Judy Huang, Nicholas Theodore World Neurosurgery.2024; 184: 283. CrossRef
Comparison of the Medium‐term Outcomes of Anterior Lumbar Discectomy and Fusion with Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Retrospective Cohort Study Chao Song, Zhibo Deng, Hanhao Dai, Wu Zheng, Guoyu Yu, Yijing Wu, Jun Luo, Jie Xu Orthopaedic Surgery.2024; 16(5): 1042. CrossRef
Pushing the Limits of Minimally Invasive Spine Surgery—From Preoperative to Intraoperative to Postoperative Management Peter N. Drossopoulos, Arnav Sharma, Favour C. Ononogbu-Uche, Troy Q. Tabarestani, Alyssa M. Bartlett, Timothy Y. Wang, David Huie, Oren Gottfried, Jeanna Blitz, Melissa Erickson, Shivanand P. Lad, W. Michael Bullock, Christopher I. Shaffrey, Muhammad M. Journal of Clinical Medicine.2024; 13(8): 2410. CrossRef
Do nutritional assessment tools (PNI, CONUT, GNRI) predict adverse events after spinal surgeries? A systematic review and meta-analysis Zhi Huang, Hanbo Wang, Yifeng Da, Shengxiang Liu, Wenkai Zheng, Feng Li Journal of Orthopaedic Surgery and Research.2024;[Epub] CrossRef
Trends in degenerative lumbar spinal surgery during the early COVID-19 pandemic in Republic of Korea: A national study utilizing the national health insurance database Woon Tak Yuh, Jinhee Kim, Mi-Sook Kim, Jun-Hoe Kim, Young Rak Kim, Sum Kim, Chun Kee Chung, Chang-Hyun Lee, Sung Bae Park, Kyoung-Tae Kim, John M. Rhee, Young San Ko, Chi Heon Kim, Kentaro Yamada PLOS ONE.2024; 19(6): e0305128. CrossRef
Evolution, Current Trends, and Latest Advances of Endoscopic Spine Surgery Sharvari Gunjotikar, Malcolm Pestonji, Masato Tanaka, Tadashi Komatsubara, Shashank J. Ekade, Ahmed Majid Heydar, Huynh Kim Hieu Journal of Clinical Medicine.2024; 13(11): 3208. CrossRef
A novel endoscope-port unit for lumbar microendoscopic surgery: a single-center case series review Vicente de Paulo Martins Coelho Junior, Anthony M. Alvarado, Richard G. Fessler Neurosurgical Review.2024;[Epub] CrossRef
Three-dimensional endoscopy in lumbar spine surgery as a novel approach for degenerative pathologies: a case report Alison Ma, Nathan Xie, Joseph Reidy, Ralph Jasper Mobbs Journal of Surgical Case Reports.2024;[Epub] CrossRef
Enhancing Cadaver Labs for Endoscopic Spine Surgery: The Glove as the “Lesion” Gaetano De Biase, Oluwaseun O. Akinduro, Stephen M. Pirris World Neurosurgery.2024; 191: e341. CrossRef
The evolution and integration of technology in spinal neurosurgery: A scoping review Moksada Regmi, Weihai Liu, Shikun Liu, Yuwei Dai, Ying Xiong, Jun Yang, Chenlong Yang Journal of Clinical Neuroscience.2024; 129: 110853. CrossRef
Assessment of Clinical Outcomes and Pain Management of Single-Level Lumbar Laminectomy Between Unilateral Biportal Endoscopic, Tubular, and Open Approaches Samuel Ezeonu, Nicholas Vollano, Alyssa Capasso, Juan Rodriguez-Rivera, Constance Maglaras, Tina Raman, Yong H. Kim, Charla R. Fischer Journal of Minimally Invasive Spine Surgery and Technique.2024; 9(2): 94. CrossRef
INTERVERTEBRAL FORAMEN ANATOMY OF THE LUMBAR SPINE: AN OVERVIEW JOãO PAULO MACHADO BERGAMASCHI, BERNARDO JOSé MOREIRA CHAVES, CARLOS ANDRé ROCHA CAMPOS, MARCELO GIACOMIN DA FONSECA, VICTOR MORALE, LUíS FERNANDO TIRAPELLI, FERNANDA WIRTH Coluna/Columna.2024;[Epub] CrossRef
Less Is More: Evaluating the Benefits of Minimally Invasive Spinal Surgery Ali A. Mohamed, Rakan Alshaibi, Steven Faragalla, Garrett Flynn, Asad Khan, Emma Sargent, Youssef Mohamed, Camberly Moriconi, Cooper Williams, Zev Karve, Daniel Colome, Phillip Mitchell Johansen, Brandon Lucke-Wold Life.2024; 15(1): 8. CrossRef
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. CrossRef
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. CrossRef
Commentary on “The Role and Clinical Outcomes of Endoscopic Spine Surgery of Treating Spinal Metastases; Outcomes of 29 Cases From 8 Countries” Wongthawat Liawrungrueang, Vit Kotheeranurak Neurospine.2023; 20(2): 620. CrossRef
There Is No Spine Surgery Without the Risk of Complications: A Deep Dive Into the Realm of Minimally Invasive and Endoscopic Spine Surgery Jeong-Yoon Park, Arvind G Kulkarni Journal of Minimally Invasive Spine Surgery and Technique.2023; 8(Suppl 1): S1. CrossRef
Development of Indications for Endoscopic Spine Surgery: An Overview Fernanda Wirth, Esthael Cristina Querido Avelar Bergamaschi, Fábio da Silva Forti, João Paulo Machado Bergamaschi International Journal of Translational Medicine.2023; 3(3): 321. CrossRef
Overview and Prevention of Complications During Full-Endoscopic Cervical Spine Surgery Young-Rak Kim, Jun-Hoe Kim, Tae-Hwan Park, Hangeul Park, Sum Kim, Chang-Hyun Lee, Kyoung-Tae Kim, Chun Kee Chung, Chi Heon Kim Journal of Minimally Invasive Spine Surgery and Technique.2023; 8(2): 153. CrossRef
Near infrared imaging system for preventing blood vision obstruction in endoscopy Meng-Huang Wu, Jason C. Hsu, Jin-Sung Kim, Tsung-Jen Huang, Yi-Hung Huang, Hon Pan Yiu, Ching-Yu Lee, Jowy Tani, Cheng-Chun Chang Optics Express.2023; 31(26): 43877. CrossRef
Interlaminar Endoscopic Lumbar Discectomy Versus Microscopic Lumbar Discectomy: A Preliminary Analysis of L5–S1 Lumbar Disc Herniation Outcomes in Prospective Randomized Controlled Trials Yanting Liu, Youngjin Kim, Chan Woong Park, Siravich Suvithayasiri, Khanathip Jitpakdee, Jin-Sung Kim Neurospine.2023; 20(4): 1457. CrossRef
The Endoscopic Lumbar Interbody Fusion: A Narrative Review, and Future Perspective Phattareeya Pholprajug, Vit Kotheeranurak, Yanting Liu, Jin-Sung Kim Neurospine.2023; 20(4): 1224. CrossRef
Objective To identify potential risk factors of unsatisfactory screw position during robot-assisted pedicle screw fixation.
Methods A retrospective analysis of robot-assisted pedicle screw fixation performed in Beijing Jishuitan Hospital from March 2018 to March 2019 was conducted. Research data was collected from the medical record and imaging systems. Univariate tests were performed on the potential risk factors (patient’s characteristics and surgical factors) of unsatisfactory screw position during robot-assisted pedicle screw fixation. For statistically significant variables in univariate tests, a logistic regression test was used to identify independent risk factors for unsatisfactory screw position.
Results A total of 780 pedicle screws placed in 163 robot-assisted surgeries were analyzed. The rate of perfect screw positions was 93.08%, and the unsatisfactory rate was 6.92%. In patients with severe obesity (body mass index ≥ 30 kg/m2) (odds ratio [OR], 2.459; 95% confidence interval [CI], 1.199–5.044; p = 0.014), osteoporosis (T ≤ -2.5) (OR, 1.857; 95% CI, 1.046–3.295; p = 0.034), and the segments 3 levels away from the tracker (OR, 2.216; 95% CI, 1.119–4.387; p = 0.022), robot-assisted pedicle screw placement has a higher risk of screw malposition.
Conclusion During robot-assisted pedicle screw placement for patients with severe obesity, osteoporosis, and segments 3 levels away from the tracker, vigilance should be maintained during surgery to avoid postoperative complications due to unsatisfactory screw position.
Citations
Citations to this article as recorded by
Feasibility of synthetic CT images for robotic pedicle screw planning and navigation Ardavan Kashtiara, Sarah Beldé, Dieter Thijs, Timo De Bondt, Johan Van Goethem, Erik Van de Kelft European Spine Journal.2026; 35(3): 1354. CrossRef
Power-drill fluoroscopy-controlled technique as an alternative to navigation-assisted pedicle screw placement: A propensity score-matched retrospective cohort study Felix Corr, Faizan Kareem, Linda Bättig, Benedict Caspari, Karl Kapahnke, Silvio Heinig, Simon Behringer, Erik Schulz, Yesim Yildiz, Nader Hejrati, Oliver Bozinov, Benjamin Martens, Kern Singh, Martin N. Stienen, Stefan Motov Brain and Spine.2026; 6: 105959. CrossRef
Spinal Robotics in Adult Spinal Deformity Surgery: Key Concepts and Technical Considerations Kareem Khalifeh, Carson P. McCann, Nicholas S. Hernandez, Martin H. Pham Asian Journal of Neurosurgery.2025; 20(03): 448. CrossRef
Factors causing deviation of robot-assisted pedicle screw placement for adolescent idiopathic scoliosis: why does deviation still occur even with robotics? Jun Ueno, Yoshiaki Torii, Masahiro Iinuma, Atsuhiro Yoshida, Ken Tomochika, Takahiro Hideshima, Makoto Ito, Tsutomu Akazawa European Spine Journal.2025; 34(7): 2714. CrossRef
Robotic-Guided Spine Surgery: Implementation of a System in Routine Clinical Practice—An Update Mirza Pojskić, Miriam Bopp, Omar Alwakaa, Christopher Nimsky, Benjamin Saß Journal of Clinical Medicine.2025; 14(13): 4463. CrossRef
Complications and Errors With Spinal Robotics and Navigation Trice A. Pickens, Cade F. Bennett, Daniel E. Herrera, Wellington K. Hsu, Srikanth N. Divi, Alpesh A. Patel Contemporary Spine Surgery.2025; 26(9): 1. CrossRef
Risk factors of inaccurate screw placement in robotic spine surgeries: why do robots make error and how to avoid them? S. Vidyadhara, R Dinesh Iyer, Abhishek Soni, T. Balamurugan, Dhiyanesh Krishnamurthy Journal of Robotic Surgery.2025;[Epub] CrossRef
Risk factors analysis for pedicle screw placement deviation in robot-assisted MIS-TLIF Tianci Yang, Beixi Bao, Hui Yan, Yuxuan Wu, Xiaokang Cheng, Chunyang Xu, Yang Ye, Haoran Zhang, Jiaguang Tang BMC Surgery.2025;[Epub] CrossRef
A Retrospective Cohort Study Comparing Robot-Assisted and Conventional Fluoroscopy-Guided Pedicle Screw Placement Hassan Seif, Emanuele Maragno, Marco Gallus, Szabolcs Szeöke, Michael Schwake Journal of Clinical Medicine.2025; 14(19): 6831. CrossRef
Accuracy and potential risk factors of pedicle screw placement using a noninvasive-registration robotic system in the thoracolumbar spine Rui Yang, Kui Wang, Weilin Li, Jiajun Feng, Jian Jiang, Yuefeng Sun, Hong Wang Journal of Robotic Surgery.2025;[Epub] CrossRef
Accuracy and risk factors of Magerl screw placement in robot‐assisted atlantoaxial surgery: A case series study Wu Jiayuan, Wei Yi, Duan Fangfang, He Da, Jiang Xieyuan, Tian Wei The International Journal of Medical Robotics and Computer Assisted Surgery.2024;[Epub] CrossRef
A Single-Center Experience of Robotic-Assisted Spine Surgery in Korea : Analysis of Screw Accuracy, Potential Risk Factor of Screw Malposition and Learning Curve Bu Kwang Oh, Dong Wuk Son, Jun Seok Lee, Su Hun Lee, Young Ha Kim, Soon Ki Sung, Sang Weon Lee, Geun Sung Song, Seong Yi Journal of Korean Neurosurgical Society.2024; 67(1): 60. CrossRef
Accuracy and clinical characteristics of robot-assisted cervical spine surgery: a systematic review and meta-analysis Jiayuan Wu, Mingxing Fan, Da He, Yi Wei, Fangfang Duan, Xieyuan Jiang, Wei Tian International Orthopaedics.2024; 48(7): 1903. CrossRef
Feasibility and safety report on robotic assistance for cervical pedicle screw fixation: a cadaveric study Seungjun Ryu, Byeong-Jin Ha, Sunjin Yoon, Chang Kyu Lee, Dong Ah Shin, Keung-Nyun Kim, Seong Yi Scientific Reports.2024;[Epub] CrossRef
Level-specific comparison of 3D navigated and robotic arm-guided screw placement: an accuracy assessment of 1210 pedicle screws in lumbar surgery Tomoyuki Asada, Tejas Subramanian, Chad Z. Simon, Nishtha Singh, Takashi Hirase, Kasra Araghi, Amy Z. Lu, Eric Mai, Yeo Eun Kim, Olivia Tuma, Myles R J Allen, Eric Kim, Maximilian Korsun, Joshua Zhang, Cole Kwas, James Dowdell, Sravisht Iyer, Sheeraz A. Q The Spine Journal.2024; 24(10): 1872. CrossRef
Mazor X robot-assisted upper and lower cervical pedicle screw fixation: a case report and literature review Zilin Gao, Xiaobo Zhang, Zhengwei Xu, Chao Jiang, Wei Hu, Haiping Zhang, Dingjun Hao BMC Geriatrics.2024;[Epub] CrossRef
Response to letter to the editor regarding “Level-specific comparison of 3D navigated and robotic arm-guided screw placement: an accuracy assessment of 1210 pedicle screws in lumbar surgery” Tomoyuki Asada, Sheeraz A. Qureshi The Spine Journal.2024; 24(12): 2430. CrossRef
Clinical application of spinal robot in cervical spine surgery: safety and accuracy of posterior pedicle screw placement in comparison with conventional freehand methods Lu-Ping Zhou, Ren-Jie Zhang, Wen-Kui Zhang, Liang Kang, Kai-Xuan Li, Hua-Qing Zhang, Chong-Yu Jia, Yin-Shun Zhang, Cai-Liang Shen Neurosurgical Review.2023;[Epub] CrossRef
Robotic navigation during spine surgery: an update of literature Qi Zhang, Xiao-Guang Han, Ming-Xing Fan, Jing-Wei Zhao, Zhao Lang, Ji-Le Jiang, Da He, Bo Liu, Wei Tian Expert Review of Medical Devices.2023; 20(6): 427. CrossRef
Robotics in Cervical Spine Surgery: Feasibility and Safety of Posterior Screw Placement Lu-Ping Zhou, Zhi-Gang Zhang, Dui Li, Shu Fang, Rui Sheng, Ren-Jie Zhang, Cai-Liang Shen Neurospine.2023; 20(1): 329. CrossRef
Effects of tracer position on screw placement technique in robot-assisted posterior spine surgery: a case–control study Meng Yi, Jipeng Song, Yao Zhang, Wancheng Lin, Mingtao Yao, Yuyu Fan, Lixiang Ding BMC Musculoskeletal Disorders.2023;[Epub] CrossRef
A Novel Free‐hand Technique of Pedicle Screw Placement in the Lumbar Spine: Accuracy Evaluation and Preliminary Clinical Results Weiqi Jiang, Ao Leng, Lingzhi Meng, Zuoyao Long, Yu Long, Qi Wang Orthopaedic Surgery.2023; 15(9): 2260. CrossRef
Severe Obesity Is an Independent Risk Factor of Early Readmission and Nonhome Discharge After Cervical Disc Replacement Tejas Subramanian, Daniel Shinn, Pratyush Shahi, Izzet Akosman, Troy Amen, Omri Maayan, Eric Zhao, Kasra Araghi, Junho Song, Sidhant Dalal, James Dowdell, Sravisht Iyer, Sheeraz Qureshi Neurospine.2023; 20(3): 890. CrossRef
Three-Dimensional Quantitative Assessment of Pedicle Screw Accuracy in Clinical Utilization of a New Robotic System in Spine Surgery: A Multicenter Study Byeong-Jin Ha, Jong-Min Lee, Seon-Jin Yoon, Byung-Kwan Kim, Junseok Lee, Suhun Lee, Seungjae Ryu, Yongyeob Cha, Sungteac Hwang, Donggi Woo, Chang Kyu Lee, Dong Ah Shin, Yoon Ha, Sung Uk Kuh, Keung Nyun Kim, Dongwuk Son, Seong Yi Neurospine.2023; 20(3): 1028. CrossRef
Assessing the Accuracy of Spinal Instrumentation Using Augmented Reality (AR): A Systematic Review of the Literature and Meta-Analysis Bhavya Pahwa, Tej D. Azad, Jiaqi Liu, Kathleen Ran, Connor J. Liu, Jovanna Tracz, Shahab Aldin Sattari, Jawad M. Khalifeh, Brendan F. Judy, Ali Bydon, Timothy F. Witham Journal of Clinical Medicine.2023; 12(21): 6741. CrossRef
Spine Surgical Robotics: Current Status and Recent Clinical Applications Jiangtao Wang, Junxian Miao, Yi Zhan, Yongchao Duan, Yuanshun Wang, Dingjun Hao, Biao Wang Neurospine.2023; 20(4): 1256. CrossRef
Posterior atlantoaxial internal fixation using Harms technique assisted by 3D-based navigation robot for treatment of atlantoaxial instability Zhao Lang, Xiaoguang Han, Mingxing Fan, Yajun Liu, Da He, Wei Tian BMC Surgery.2022;[Epub] CrossRef
Comparison of accuracy and safety between second-generation TiRobot-assisted and free-hand thoracolumbar pedicle screw placement Kai Yan, Qi Zhang, Wei Tian BMC Surgery.2022;[Epub] CrossRef
Development and Clinical Trial of a New Orthopedic Surgical Robot for Positioning and Navigation Jie Chang, Lipeng Yu, Qingqing Li, Boyao Wang, Lei Yang, Min Cheng, Feng Wang, Long Zhang, Lei Chen, Kun Li, Liang Liang, Wei Zhou, Weihua Cai, Yongxin Ren, Zhiyi Hu, Zhenfei Huang, Tao Sui, Jin Fan, Junwen Wang, Bo Li, Xiaojian Cao, Guoyong Yin Journal of Clinical Medicine.2022; 11(23): 7091. CrossRef
First
Prev
