Kim Hyeun Sung, Wu Pang Hung, Jang Il-Tae
Department of Spine Surgery, Nanoori Gangnam Hospital, Seoul, Republic of South Korea.
Department of Spine Surgery, Nanoori Gangnam Hospital, Seoul, Republic of South Korea; Department of Orthopaedic Surgery, National University Health System, Jurong Health Campus, Singapore.
World Neurosurg. 2020 Aug;140:642-653. doi: 10.1016/j.wneu.2020.03.111.
The aging population around the world leads to increasing incidence of degenerative spinal conditions. There is a need for a minimally invasive technique in treatment for spinal conditions to meet the medical complexity and comorbidities that comes with aging. Principles of endoscopy are similar to minimally invasive surgery, which is to decrease pressure on soft tissue crushing from prolonged retraction, avoid soft tissue stripping and dissection, and bone and ligamentous preservation for optimal decompression without excessive destruction. Endoscopic spine surgery techniques started slowly in development in the 1970s to 2000s, with a rapid phase of development since the turn of the 21st century with endoscopic solutions developing in cervical, thoracic, and lumbar conditions with increasing complexity in nature of operation. Technological enhancement with progressively supportive literature is pushing boundaries of endoscopy from the early days of soft tissue procedure to current fusion procedures, endoscopic spine surgery techniques is covering more areas of spine than ever previously possible with good clinical results. We present a review on the current techniques available and postulated near future development for endoscopic spine surgery.
全球人口老龄化导致退行性脊柱疾病的发病率不断上升。需要一种用于脊柱疾病治疗的微创技术，以应对老龄化带来的医疗复杂性和合并症。内窥镜检查的原理与微创手术相似，即减少因长时间牵拉对软组织造成的挤压压力，避免软组织剥离和解剖，并保留骨骼和韧带以实现最佳减压，同时避免过度破坏。内窥镜脊柱手术技术在20世纪70年代至21世纪初发展缓慢，自21世纪之交以来进入快速发展阶段，针对颈椎、胸椎和腰椎疾病开发了内窥镜解决方案，手术性质日益复杂。随着文献支持的不断增加，技术不断进步，推动内窥镜检查从早期的软组织手术发展到目前的融合手术，内窥镜脊柱手术技术覆盖的脊柱区域比以往任何时候都更多，且临床效果良好。我们对当前可用的内窥镜脊柱手术技术以及对其不久的将来发展的推测进行综述。
