Full-Endoscopic Spine Surgery : Its Roles and Limitations.

IF 1.4 4区 医学 Q4 CLINICAL NEUROLOGY
Yong Ahn
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Abstract

Endoscopic spine surgery is the perfect culmination of the concept of minimally invasive spine surgery. Among the various endoscopic spine procedures, full-endoscopic spine surgery (FESS) is an endoscopic technique characterized by the performance of the entire spinal procedure via the percutaneous approach using a uniportal working-channel endoscope with continuous saline perfusion. FESS effectively decompresses the tissues and allows for instrumentation while preserving the normal musculoskeletal structures. It also has fewer complications and enables quicker return to work. However, potential disadvantages include its steep learning curves and limited indications. Previously, the indications for endoscopic procedures had been limited to soft disc herniations or focal neural impingement, with most degenerative spinal diseases other than disc herniation being considered contraindications. However, owing to the remarkable advancements in endoscopic technology, nearly all degenerative spinal diseases, including spinal stenosis and instability, can currently be treated using FESS. Furthermore, the application of spinal endoscopes has expanded to other spinal disorders, including infections, traumas, and tumors. Unfortunately, the steep learning curve and technical limitations of FESS cannot be overlooked by most standard spine surgeons. To ensure the clinical success of endoscopic procedures in actual clinical practice, a comprehensive understanding of the core properties of working channel endoscopes is necessary to facilitate the learning process. With the ongoing development of endoscopic technology, endoscopic surgery can be expected to become the standard treatment approach for all degenerative spinal diseases in the near future.

全内窥镜脊柱手术:它的作用和局限性。
内窥镜脊柱手术是微创脊柱手术概念的完美顶点。在各种内窥镜脊柱手术中,全内窥镜脊柱手术(FESS)是一种内窥镜技术,其特点是使用单门工作通道内窥镜在持续盐水灌注下经皮入路完成整个脊柱手术。FESS有效地减压组织,在保留正常肌肉骨骼结构的同时允许内固定。它也有更少的并发症,可以更快地恢复工作。然而,潜在的缺点包括其陡峭的学习曲线和有限的适应症。以前,内窥镜手术的适应症仅限于软椎间盘突出或局灶性神经撞击,除椎间盘突出外,大多数退行性脊柱疾病被认为是禁忌症。然而,由于内窥镜技术的显著进步,目前几乎所有退行性脊柱疾病,包括椎管狭窄和不稳定,都可以使用FESS治疗。此外,脊髓内窥镜的应用已经扩展到其他脊柱疾病,包括感染、创伤和肿瘤。不幸的是,FESS的陡峭的学习曲线和技术限制不能被大多数标准脊柱外科医生忽视。为了确保内窥镜手术在实际临床实践中的临床成功,全面了解工作通道内窥镜的核心特性是促进学习过程的必要条件。随着内镜技术的不断发展,内镜手术有望在不久的将来成为所有退行性脊柱疾病的标准治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
6.20%
发文量
109
审稿时长
3-8 weeks
期刊介绍: The Journal of Korean Neurosurgical Society (J Korean Neurosurg Soc) is the official journal of the Korean Neurosurgical Society, and published bimonthly (1st day of January, March, May, July, September, and November). It launched in October 31, 1972 with Volume 1 and Number 1. J Korean Neurosurg Soc aims to allow neurosurgeons from around the world to enrich their knowledge of patient management, education, and clinical or experimental research, and hence their professionalism. This journal publishes Laboratory Investigations, Clinical Articles, Review Articles, Case Reports, Technical Notes, and Letters to the Editor. Our field of interest involves clinical neurosurgery (cerebrovascular disease, neuro-oncology, skull base neurosurgery, spine, pediatric neurosurgery, functional neurosurgery, epilepsy, neuro-trauma, and peripheral nerve disease) and laboratory work in neuroscience.
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