Current Indications for Spinal Endoscopic Surgery and Potential for Future Expansion

Chen, Kuo-Tai; Kim, Jin-Sung; Huang, Abel Po-Hao; Lin, Martin; Chen, Chien‐Min

doi:10.14245/ns.2346190.095

Cited by 18 publications

(14 citation statements)

References 60 publications

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“…Finally, some potential confounding factors, such as smoking, physical activity, and medication history, were not included in the analysis because of the retrospective design of the study. Further prospective studies with larger sample sizes and longer follow-up periods are required to confirm these findings and address these limitations [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Cervical Biportal Endoscopic Spine Surgery and Anterior Cervical Discectomy and Fusion in Patients with Symptomatic Cervical Disc Herniation

Jung,

Gunadala,

Kim

2024

JCM

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Background: We aimed to analyze the clinical outcomes and effectiveness of cervical biportal endoscopic spine surgery (C-BESS) and anterior cervical discectomy and fusion (ACDF) in patients with symptomatic cervical disc herniation. Methods: This study was a retrospective chart review of four-year clinical data involving 318 cases of symptomatic cervical disc herniation, with 156 patients undergoing the ACDF and 162 patients receiving the C-BESS. Preoperative and postoperative one-year data were collected. Results: The numeric rating scale and neck disability index showed statistically significant improvement for both ACDF and C-BESS groups. While showing a longer operation time and more blood loss during surgery compared to the ACDF group, the C-BESS group demonstrated a learning effect as the surgeon’s proficiency increased with more cases. There was no significant difference in the postoperative length of hospitalization between the two methods. The subgroup with predominant arm pain revealed the statistical difference in arm pain intensity changes between the two groups (p < 0.001). The rates of complication were 2.6% for the ACDF group and 1.9% for the C-BESS group. Conclusions: C-BESS and ACDF are effective surgical treatments for patients with symptomatic single-level cervical disc herniation in relieving relevant pain intensities and pain-related disabilities.

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Section: Discussionmentioning

confidence: 99%

Comparison of Cervical Biportal Endoscopic Spine Surgery and Anterior Cervical Discectomy and Fusion in Patients with Symptomatic Cervical Disc Herniation

Jung,

Gunadala,

Kim

2024

JCM

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“…A growing number of spinal endoscopic procedures have been reported using more advanced optical systems, improved instruments, and effective coagulation equipment 61 . These advances have also coincided with the extension of spinal endoscopic techniques from the treatment of lumbar spine diseases to the management of cervical and thoracic spinal diseases ranging from disk herniation to spinal stenosis 62 . The number of studies regarding the endoscopic treatment of TOLF has trended upward over time (Fig.…”

Section: Discussionmentioning

confidence: 99%

“… 61 These advances have also coincided with the extension of spinal endoscopic techniques from the treatment of lumbar spine diseases to the management of cervical and thoracic spinal diseases ranging from disk herniation to spinal stenosis. 62 The number of studies regarding the endoscopic treatment of TOLF has trended upward over time (Fig. 12 ).…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy Outcomes Following Spinal Endoscopic Procedures for Thoracic Ligamentous Ossification

Ye,

Guo,

et al. 2023

Spine

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Study Design. Systematic review and meta-analysis. Objective. This study systematically reviewed and evaluated the safety and efficacy of spinal endoscopic techniques as a treatment for thoracic ligamentum flavum ossification (TOLF). Summary of Background Data. The use of spinal endoscopic techniques for the treatment of TOLF has increased in recent years. The present study is the first comprehensive systematic review and meta-analysis focused on the use of spinal endoscopic techniques for TOLF. Methods. The Cochrane Central, PubMed, Web of Science, and Embase databases were systematically searched for studies focused on patients undergoing spinal endoscopic techniques to treat symptomatic TOLF. Results. This meta-analysis included 23 studies. We included 323 patients (177 males, 146 females) with a mean age of 58.40±10.06 years, with 304 total recorded lesion locations of which 245 were located in the lower thoracic spine. Complications affected 35/323 patients, and the mean operative duration for 305 patients was 108.15±47.34 minutes. For 187 patients, the mean operative bleeding was 25.13±12.54 mL, while for 87 patients the mean duration of hospitalization was 4.59±1.93 days. At last follow-up，functional assessment was performed for 260 patients, of whom 200 were in excellent condition, visual analog scale (VAS) scores were assessed for 160 patients, with a mean improvement of 4.40 (3.95,4.86) Japanese Orthopedic Association (JOA) scores were recorded for 115 patients, with a mean improvement of 2.99 (2.77,3.22) , and modified Japanese Orthopedic Association (mJOA) scores were recorded for 208 patients, with a mean improvement of 3.41 (3.17,3.64) . Conclusions. These results support several advantages of spinal endoscopic techniques for the treatment of symptomatic TOLF. These include low complication rates, rapid postoperative recovery, and good functional recovery when used for single-segment, non-nodular ossification and no combined dural ossification.

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“…During the COVID-19 pandemic, surgeons and patients might have preferred less invasive decompression surgery to fusion surgery, taking into account postoperative care and the hospital stay. 13,[36][37][38][39] However, that explanation would be inconsistent with the increased proportion of fusion surgery in spinal stenosis. Without detailed clinical information in each case, the exact cause of the change remains unexplainable.…”

Section: Changes During Hospital Staysmentioning

confidence: 99%

Trends in Degenerative Lumbar Spinal Surgery During the Early COVID-19 Pandemic in Republic of Korea: A National Study Utilizing the National Health Insurance Database

Yuh,

Kim,

Kim

et al. 2023

Preprint

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During the first year of the COVID-19 pandemic, the Republic of Korea (ROK) experienced three epidemic waves in February, August, and November 2020. These waves, combined with the overarching pandemic, significantly influenced trends in spinal surgery. The primary aim of this study was to investigate the trends in degenerative lumbar spinal surgery in ROK during the early COVID-19 pandemic, especially in relation to specific epidemic waves. The secondary aim was to compare surgical outcomes, including length of hospital stay (LOH), hospital costs, discharge disposition, the 30-day readmission rate, and the reoperation rate, between periods before and during the pandemic. A retrospective analysis of ROK’s national health information database (NHID) was conducted on all patients who underwent surgery for degenerative lumbar spinal diseases. Two cohorts were established: pre-COVID-19 (January to December 2019) and COVID-19 (January to December 2020). Propensity score matching and joinpoint regression were utilized. During the first year of the COVID-19 pandemic, the number of surgeries decreased following the first and second epidemic waves (p < 0.01 and p = 0.21, respectively), but these were offset by compensatory increases later on (both p < 0.01). However, the third epidemic wave did not lead to a decrease in surgical volume, and the total number of surgeries remained comparable to the period before the pandemic. LOH was reduced by 1 day (p < 0.01), while mean hospital costs increased significantly from 3,472 to 4,042 USD (p < 0.01). Additionally, both the transfer rate and the 30-day readmission rate significantly decreased (both p < 0.01), while the reoperation rate remained stable (p = 0.73). Despite the substantial impact of the early epidemic waves on degenerative lumbar spinal surgery, the overall number of operations and surgical outcomes during the early COVID-19 pandemic were comparable to pre-pandemic levels. These findings suggest that lumbar spinal surgery may not need to halt due to a pandemic. These insights should be widely disseminated to inform and guide future strategies in managing similar health crises.

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Current Indications for Spinal Endoscopic Surgery and Potential for Future Expansion

Cited by 18 publications

References 60 publications

Comparison of Cervical Biportal Endoscopic Spine Surgery and Anterior Cervical Discectomy and Fusion in Patients with Symptomatic Cervical Disc Herniation

Comparison of Cervical Biportal Endoscopic Spine Surgery and Anterior Cervical Discectomy and Fusion in Patients with Symptomatic Cervical Disc Herniation

Safety and Efficacy Outcomes Following Spinal Endoscopic Procedures for Thoracic Ligamentous Ossification

Trends in Degenerative Lumbar Spinal Surgery During the Early COVID-19 Pandemic in Republic of Korea: A National Study Utilizing the National Health Insurance Database

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