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Kim and Wu: Paradigm Shift in Spinal Surgery
Advancement in medical treatment leads to increase life expectancy and population ageing. The corresponding increase in the incidence of degenerative spinal conditions are top 10 causes of disabilities worldwide [1]. As science advances with new procedures, there is a demand for more advanced technology and surgical techniques in spinal surgery to minimise collateral soft tissue damages to provide improved clinical outcomes with less perioperative morbidities for our patients. This demand gives rise to the evolution of endoscopic spine surgery [2]. Despite the many benefits of spinal endoscopy, there is a steep learning curve in spinal endoscopy [3]. Surgeons who are practicising the art of spinal endoscopy should be familiar with open surgical techniques and spinal anatomy. As endoscopic spine surgery is a fast evolving field, it is important for practicing endosocpic surgeon to keep current with the latest literature and updates. Since the previous special edition of Endoscopic Spine Surgery in Neurospine in 2020, there is continual development of technology in spinal endoscope in terms of lens clarity, variety of angulation, light transmission, radiofrequency energy systems, spinal endoscopic instruments, and further refinement of surgical techniques by worldwide endoscopic surgeons. This leads to an expansion of clinical indications for endoscopic spine surgery [4-8]. In this special edition, we have articles from uniportal full endoscopic and unilateral biportal endoscopy addressing various conditions in spine with advanced endoscopic techniques involving cervical and thoracic decompression as well as endoscopic spinal fusion techniques.
We are confident this current special issue of Endoscopic Spine Surgery in Neurospine will become a core forum for spine scholars who are interested in endoscopic spine surgery. We wish you success in your academic, clinical and endoscopic spine surgical career.


Conflict of Interest

The authors have nothing to disclose.


1. Daniels AH, Gundle K, Hart RA. Collateral adverse outcomes after lumbar spine surgery. Instr Course Lect 2016;65:291-7.
2. Kim M, Kim HS, Oh SW, et al. Evolution of spinal endoscopic surgery. Neurospine 2019;16:6-14.
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3. Wu PH, Kim HS, Choi DJ, et al. Overview of tips in overcoming learning curve in uniportal and biportal endoscopic spine surgery. J Minim Invasive Spine Surg Tech 2021;6(Suppl 1):S84-96.
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4. Wu PH, Kim HS, Jang IT. A narrative review of development of full-endoscopic lumbar spine surgery. Neurospine 2020;17(Suppl 1):S20-33.
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5. Kim HS, Wu PH, Jang IT. Development of endoscopic spine surgery for healthy life: to provide spine care for better, for worse, for richer, for poorer, in sickness and in health. Neurospine 2020;17(Suppl 1):S3-8.
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6. Xu J, Wang D, Liu J, et al. Learning curve and complications of unilateral biportal endoscopy: cumulative sum and riskadjusted cumulative sum analysis. Neurospine 2022;19:792-804.
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7. Kim JY, Hong HJ, Lee DC, et al. Comparative analysis of 3 types of minimally invasive posterior cervical foraminotomy for foraminal stenosis, uniportal-, biportal endoscopy, and microsurgery: radiologic and midterm clinical outcomes. Neurospine 2022;19:212-23.
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8. Park MK, Son SK, Park WW, et al. Unilateral biportal endoscopy for decompression of extraforaminal stenosis at the lumbosacral junction: surgical techniques and clinical outcomes. Neurospine 2021;18:871-9.
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