El Choueiri Jad, Pellicanò Francesca, Caimi Edoardo, Laurelli Francesco, Di Cosmo Leonardo, Darwiche Rada Ali, Cernigoi Daniel, Perera Molligoda Arachchige Arosh S, Cracchiolo Giorgio, Creatura Donato, Baram Ali, Brembilla Carlo, Capo Gabriele
Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy.
School of Medicine and Surgery, University of Milano-Bicocca, 24127 Bergamo, Milan, Italy.
J Clin Med. 2025 May 24;14(11):3685. doi: 10.3390/jcm14113685.
Endoscopic spine surgery (ESS) has traditionally been employed for lumbar disc herniation (LDH). Recent innovations in surgical methods and technologies have expanded its range to address other spinal pathologies, providing minimally invasive solutions with potential clinical benefits. Our review aims to summarize the applications, clinical outcomes, and limitations of ESS beyond LDH, focusing on its role in complex spinal conditions such as stenosis, thoracic disc herniation, spinal tumors, synovial cysts, and failed back surgery syndrome. A thorough review of the literature was conducted to assess and summarize the current evidence regarding ESS applications for spinal conditions beyond LDH surgery. Areas of focus included innovations in technology and technique, as well as comparisons with conventional open surgical methods. ESS shows notable potential across different spinal conditions by providing minimally invasive alternatives to traditional open surgery. Its use could be associated with reduced surgical morbidity, shorter recovery times, and improved patient outcomes. In particular, ESS is versatile in addressing both degenerative and neoplastic conditions of the spine. Despite this, challenges such as technical complexity, steep learning curves, and limited indications for certain pathologies remain as barriers to wider adoption. ESS is evolving in spine surgery, extending its utility beyond LDH surgery. While the current evidence largely supports its clinical efficacy, further studies are needed to address the present limitations and optimize its application. Future developments in surgical training and technology will likely enhance its adoption and broaden its clinical indications.
传统上，内镜脊柱手术（ESS）一直用于治疗腰椎间盘突出症（LDH）。手术方法和技术的最新创新扩大了其应用范围，可用于治疗其他脊柱疾病，提供具有潜在临床益处的微创解决方案。我们的综述旨在总结ESS在LDH之外的应用、临床结果和局限性，重点关注其在复杂脊柱疾病中的作用，如椎管狭窄、胸椎间盘突出症、脊柱肿瘤、滑膜囊肿和腰椎手术失败综合征。我们对文献进行了全面回顾，以评估和总结关于ESS在LDH手术之外的脊柱疾病应用的现有证据。重点领域包括技术和技巧的创新，以及与传统开放手术方法的比较。通过为传统开放手术提供微创替代方案，ESS在不同脊柱疾病中显示出显著潜力。其使用可能与手术发病率降低、恢复时间缩短和患者预后改善有关。特别是，ESS在治疗脊柱的退行性和肿瘤性疾病方面具有通用性。尽管如此，技术复杂性、陡峭的学习曲线以及某些疾病适应症有限等挑战仍然是其更广泛应用的障碍。ESS在脊柱手术中不断发展，其应用范围已超越LDH手术。虽然目前的证据在很大程度上支持其临床疗效，但仍需要进一步研究来解决当前的局限性并优化其应用。手术培训和技术的未来发展可能会促进其应用并扩大其临床适应症。
