ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2023
2nd and 3rd generation full endoscopic lumbar spine surgery: clinical safety and learning curve.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 10 citations in OpenAlex.
- Computer-navigated transfacet uniportal endoscopic lumbar interbody fusion: a novel technique and illustrative case series.Asian spine journal · 2026Article
- The learning curve of percutaneous endoscopic interlaminar discectomy versus unilateral biportal endoscopic discectomy for lumbar disc herniation: a comparative study.Journal of orthopaedic surgery and research · 2026Article
- Endoscopic resection of lumbar intradural spinal tumors: A case series on feasibility, safety, and preliminary outcomes.Brain & spine · 2026Article
- Current Trends and Future Directions in Lumbar Spine Surgery: A Review of Emerging Techniques and Evolving Management Paradigms.Journal of clinical medicine · 2025Review
- [Digital three-dimensional assisted unilateral biportal endoscopy in treatment of highly isolated lumbar disc herniation with translaminar approach].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025Article
- Paramedian Unilateral 'Bitubular' Endoscopic Access for a Far Lateral Disc Herniation: A Novel Approach for Far Lateral Lumbar Pathologies.Neurospine · 2024Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aim2nd and 3rd generation endoscopic spine surgery techniques offer visualisation of familiar inter-laminar anatomy to spinal surgeons. We have prospectively evaluated the clinical outcome, complications and learning curve associated with these techniques in patients with lumbar spine radiculopathy.
methodsThis is a prospective study of 50 consecutive patients with radicular pain from disc herniation and/or lateral recess stenosis. In 6 patients, endoscopy couldn't be done. Operating times, PROM's (VAS, ODI and EQ-5D scores) and complication rates of 44 patients were evaluated after mean FU of 52 months (range 39-65). MRI was used to divide these into protrusions (n = 19), extrusions (n = 17) and lateral recess stenosis (n = 8). Evidence about the learning curve was gathered by curvilinear regression analyses.
resultsUsing a composite clinical success criterion, 95% patients had a successful outcome, with no major complications. ODI, VAS and EQ-5D scores had a statistically significant improvement and achieved MCID. Revision discectomy rate was only 4.5% (n = 2). MRI based grouping, case sequence and degree of difficulty influenced the duration of surgery and a learning curve was found for protrusions and lateral recess decompressions, but not for extrusions. A learning curve effect was also observed with respect to the ODI.
conclusionsAlthough anatomy visualised in 2nd and 3rd generation endoscopy is familiar to spinal surgeons, our learning curve experience suggests a careful and MRI pathology based take up of this technique in clinical practice, despite its clinical safety in our series. LEVEL OF EVIDENCE: Level 3, prospective cohort study.
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