Endoscopic Spine Surgery: A French National Survey on Practices, Motivations, and Challenges.

Abstract

Background: Endoscopic spine surgery is a minimally invasive approach that offers several advantages over the traditional open approach, including less tissue trauma, faster recovery, and lower rates of complications. However, the learning curve and the requirement of separate equipment limits the acceptability of this technique for many spine surgeons. Using a short survey, the authors sought to report the current status regarding the use of endoscopy among French spine surgeons and to identify the barriers faced by spine surgeons to adopting endoscopy into their practice.

Methods: A cross-sectional survey was conducted in which a predefined questionnaire was sent as a Google form to 522 members of the Societe Francaise de Chirurgie du Rachisspine. Respondents were asked to respond within 3 months, with reminders sent regularly to nonresponders. Responses were collected and analyzed.

Results: Among all 123 survey respondents, 39 practiced endoscopy and 84 did not practice endoscopy. Most of the surgeons acquired skills by visiting other surgeons (74.4%) or attending cadaver-based workshops (56.4%). A substantial portion of respondents were in between 1 and 3 years of experience (48.7%) and performed 5 to 10 endoscopic procedures per month(30.8%). Although 92.1% of respondents observed better outcomes in their patients with endoscopy, lack of training (26%) and high equipment cost (13.8%) were the most limiting factors reported by surgeons.

Conclusion: The results of this survey contribute to the existing literature and highlight the current trends of endoscopic spine surgery in France. Although the benefits of minimally invasive spine surgery are well documented and were confirmed by surgeons in this survey, lack of training and cost of equipment are major barriers that need to be controlled to expand the adoption of this technique.

Clinical relevance: Understanding the factors influencing the adoption of endoscopic spine surgery in France provides valuable insights for surgeons and educators. By identifying key barriers and motivations, this study may help guide strategies for improving training, accessibility, and implementation of endoscopic techniques in spinal surgery.

Level of evidence: 4: