Jitpakdee Khanathip, Liu Yanting, Heo Dong Hwa, Kotheeranurak Vit, Suvithayasiri Siravich, Kim Jin-Sung
Spine Unit, Department of Orthopaedics, Queen Savang Vadhana Memorial Hospital, Thai Red Cross Society, Chonburi, Thailand.
Spine Center, Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Eur Spine J. 2023 Aug;32(8):2755-2768. doi: 10.1007/s00586-023-07622-7. Epub 2023 Mar 1.
Endoscopic spine surgery (ESS) is a minimally invasive surgical technique that offers comparable efficacy and safety with less collateral damage compared to conventional surgery. To achieve clinical success, it is imperative to stay abreast of technological advancements, modern surgical instruments and technique, and updated evidence.
To provide a comprehensive review and updates of ESS including the nomenclature, technical evolution, bibliometric analysis of evidence, recent changes in the spine communities, the prevailing of biportal endoscopy, and the future of endoscopic spine surgery.
We conducted a comprehensive review of the literature on ESS for the mentioned topics from January 1989 to November 2022. Three major electronic databases were searched, including MEDLINE, Scopus, and Embase. Covidence Systematic Review was used to organize the eligible records. Two independent reviewers screened the articles for relevance.
In total, 312 articles were finally included for review. We found various use of nomenclatures in the field of ESS publication. To address this issue, we proposed the use of distinct terms to describe the biportal and uniportal techniques, as well as their specific approaches. In the realm of technical advancement, ESS has rapidly evolved from addressing disc herniation and spinal stenosis to encompassing endoscopic fusion, along with technological innovations such as navigation, robotics, and augmented reality. According to bibliometric analysis, China, South Korea, and the USA have accounted for almost three-quarters of total publications. The studies of the biportal endoscopy are becoming increasingly popular in South Korea where the top ten most-cited articles have been published. The biportal endoscopy technique is relatively simple to adopt, as it relies on a more familiar approach, requires less expensive instruments, has a shorter learning curve, and is also well-suited for interbody fusion. The uniportal approach provided the smallest area of soft tissue dissection. While robotics and augmented reality in ESS are not widely embraced, the use of navigation in ESS is expected to become more streamlined, particularly with the emergence of recent electromagnetic-based navigation technologies.
In this paper, we provide a comprehensive overview of the evolution of ESS, as well as an updated summary of current trends in the field, including the biportal and uniportal approaches. Additionally, we summarize the nomenclature used in ESS, present a bibliometric analysis of the field, and discuss future directions for the advancement of the field.
内镜脊柱手术（ESS）是一种微创手术技术，与传统手术相比，具有相当的疗效和安全性，且附带损伤更小。为取得临床成功，紧跟技术进步、现代手术器械和技术以及最新证据至关重要。
对ESS进行全面综述和更新，包括命名法、技术演变、证据的文献计量分析、脊柱领域的最新变化、双门内镜的流行情况以及内镜脊柱手术的未来。
我们对1989年1月至2022年11月期间关于上述主题的ESS文献进行了全面综述。检索了三个主要电子数据库，包括MEDLINE、Scopus和Embase。使用Covidence系统综述来整理符合条件的记录。两名独立评审员筛选文章的相关性。
最终共纳入312篇文章进行综述。我们发现ESS出版物领域中命名法的使用多种多样。为解决这个问题，我们提议使用不同的术语来描述双门和单门技术及其具体方法。在技术进步方面，ESS已从处理椎间盘突出和椎管狭窄迅速发展到涵盖内镜融合，同时还有导航、机器人技术和增强现实等技术创新。根据文献计量分析，中国、韩国和美国几乎占了总出版物的四分之三。双门内镜的研究在韩国越来越受欢迎，韩国发表了前十篇被引用次数最多的文章。双门内镜技术相对容易采用，因为它依赖于更熟悉的方法，需要的器械成本较低，学习曲线较短，也非常适合椎间融合。单门方法提供的软组织解剖面积最小。虽然ESS中的机器人技术和增强现实尚未被广泛接受，但预计ESS中导航的使用将变得更加简化，特别是随着最近基于电磁的导航技术的出现。
在本文中，我们提供了ESS演变的全面概述，以及该领域当前趋势的最新总结，包括双门和单门方法。此外，我们总结了ESS中使用的命名法，对该领域进行了文献计量分析，并讨论了该领域未来的发展方向。
