Liounakos Jason I, Basil Gregory W, Urakawa Hikari, Wang Michael Y
Department of Neurological Surgery, University of Miami - Miller School of Medicine, Miami, FL, USA.
Hospital for Special Surgery, New York, NY, USA.
Ann Transl Med. 2021 Jan;9(1):92. doi: 10.21037/atm-20-1119.
Endoscopic spine surgery is a burgeoning component of the minimally invasive spine surgeon's armamentarium. The goals of minimally invasive, and likewise endoscopic, spine surgery include providing equivalent or better patient outcomes compared to conventional open surgery, while minimizing soft tissue disruption, blood loss, postoperative pain, recovery time, and time to return to normal activities. A multitude of indications for the utilization of endoscopy throughout the spinal axis now exist, with applications for both decompression as well as interbody fusion. That being said, spinal endoscopy requires many spine surgeons to learn a completely new skill set and the associated learning curve may be substantial. Fluoroscopy is most common imaging modality used in endoscopic spine surgery for the localization of spinal pathology and endoscopic access. Recently, the use of navigation has been reported to be effective, with preliminary data supporting decreased operative times and radiation exposure, as well as providing for improvements in the associated learning curve. A further development is the recent interest in combining robotic guidance with spinal endoscopy, particularly with respect to endoscopic-assisted lumbar fusion. While there is currently a paucity of literature evaluating these image modalities, they are gaining traction, and future research and innovation will likely focus on these new technologies.
内镜脊柱手术是微创脊柱外科医生手术器械库中一个新兴的组成部分。微创脊柱手术以及同样的内镜脊柱手术的目标包括，与传统开放手术相比，为患者提供同等或更好的治疗效果，同时将软组织损伤、失血、术后疼痛、恢复时间以及恢复正常活动的时间降至最低。现在，在整个脊柱轴线上利用内镜有多种适应证，包括减压和椎间融合应用。话虽如此，脊柱内镜要求许多脊柱外科医生学习一整套全新的技能，并且相关的学习曲线可能很陡。荧光透视是内镜脊柱手术中用于定位脊柱病变和内镜入路的最常用成像方式。最近，有报道称导航的使用是有效的，初步数据支持缩短手术时间和减少辐射暴露，以及改善相关的学习曲线。一个进一步的发展是最近人们对将机器人引导与脊柱内镜相结合的兴趣，特别是在内镜辅助腰椎融合方面。虽然目前评估这些成像方式的文献很少，但它们正在获得关注，未来的研究和创新可能会聚焦于这些新技术。
