Kwon Hyungjoo, Park Jeong-Yoon
Department of Neurosurgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Neurospine. 2023 Mar;20(1):43-55. doi: 10.14245/ns.2346236.118. Epub 2023 Mar 31.
Many types of surgeries are changing from conventional to minimally invasive techniques. Techniques in spine surgery have also changed, with endoscopic spine surgery (ESS) becoming a major surgical technique. Although ESS has advantages such as less soft tissue dissection and normal structure damage, reduced blood loss, less epidural scarring, reduced hospital stay, and earlier functional recovery, it is not possible to replace all spine surgery techniques with ESS. ESS was first used for discectomy in the lumbar spine, but the range of ESS has expanded to cover the entire spine, including the cervical and thoracic spine. With improvements in ESS instruments (optics, endoscope, endoscopic drill and shaver, irrigation pump, and multiportal endoscopic), limitations of ESS have gradually decreased, and it is possible to apply ESS to more spine pathologies. ESS currently incorporates new technologies, such as navigation, augmented and virtual reality, robotics, and 3-dimentional and ultraresolution visualization, to innovate and improve outcomes. In this article, we review the history and current status of ESS, and discuss future goals and possibilities for ESS through comparisons with conventional surgical techniques.
许多类型的手术正在从传统技术向微创技术转变。脊柱外科手术技术也发生了变化，内镜脊柱手术（ESS）成为一种主要的外科手术技术。尽管ESS具有诸如软组织剥离和正常结构损伤少、失血减少、硬膜外瘢痕形成少、住院时间缩短以及功能恢复早等优点，但不可能用ESS取代所有脊柱手术技术。ESS最初用于腰椎间盘切除术，但ESS的范围已扩大到覆盖整个脊柱，包括颈椎和胸椎。随着ESS器械（光学设备、内窥镜、内镜钻头和刨削器、冲洗泵以及多通道内窥镜）的改进，ESS的局限性逐渐减少，并且可以将ESS应用于更多的脊柱病变。ESS目前融合了导航、增强现实和虚拟现实、机器人技术以及三维和超分辨率可视化等新技术，以创新并改善手术效果。在本文中，我们回顾了ESS的历史和现状，并通过与传统手术技术的比较来讨论ESS的未来目标和可能性。
