Here are seven trends in endoscopic spinal surgery techniques, based on an article published in the International Journal of Spine Surgery.
1. Clinical trials comparing endoscopic techniques to open posterior microdiscectomy for primary and revision lumbar disc herniations show the two groups have equivalency in outcomes.
2. Indications for endoscopic techniques continue to evolve, but limitations of the technology remain. The limitations include foraminal techniques to treat distally or proximally migrated disc fragments, which may fair better with the open micro discectomy method or more advanced interlaminar endoscopic techniques, according to the report.
3. The circumferential spinal stenosis resulting from concomitant congenital and acquired stenosis may have better outcomes with open decompressive techniques, especially if it's present at multiple levels.
4. There are improved endoscopic optics and instrumentations leading to better spinal anatomy visualization with ultra-minimally invasive approaches.
5. It takes careful patient selection to achieve the best outcomes. The location and disc pathology type as well as approach-related limitations are important considerations.
6. Endoscopic techniques can treat the central, paracentral, foraminal and far lateral lumbar disc herniations. New endoscopic systems permit posterior inter laminar lumbar decompression, anterior and posterior cervical and posterior lateral thoracic decompression.
7. Mentorship and careful cadaveric training can improve the learning curve for endoscopic techniques.