History and Basic Concepts of Full-Endoscopic Spine Surgery

Abstract

Standing and walking is the greatest privilege of humans that differentiates us from other animals. Spine surgery is one of the oldest surgical procedures dating back to the Greeks in the fifth century BC. Many experts have since been studying effective surgical methods for different spinal pathologies; however, spine surgery has been associated with longer operative time, high morbidity, and prolonged disabilities. Recent advancements in minimally invasive surgical techniques have allowed spine surgeons to overcome many of these issues. One of the most representative minimally invasive surgical techniques is endoscopic spinal surgery. Endoscopic spine surgery was introduced by P. Kambin and A. Yeung, and since its introduction in the 1990s many advances have been made. Initially, endoscopic surgery was performed using the transforaminal approach. Surgical indications have been broadened with the introduction of the interlaminar approach along with many technological advancements. Improvements in endoscopic resolution and various surgical instruments are allowing surgeons to perform endoscopic surgeries for pathologies once considered as contraindications. In particular, the introduction of surgical procedures using single portal and bi-portal systems may gradually replace classic open surgery. Therefore, it can be said that there are still many areas to explore in the field of endoscopic spine surgery. This chapter explains the history of full-endoscopic spinal discectomy, decompression technology, and a new paradigm for endoscopic spinal surgery. This history may help dictate the future of practical endoscopic spinal surgery.