Kurzfassung

Technique, indications and advantages of spinal endoscopy. Full-endoscopic spine surgery represents a further advancement of minimally invasive spine surgical techniques. Through a small skin incision measuring approximately 6–8 mm, the endoscope and surgical instruments are introduced via a common working channel (uniportal technique) and advanced into the spinal canal toward the target region. The close proximity of the optics to the neural structures, the angled viewing direction, and continuous irrigation enable a high-resolution visualization of the neural structures while minimizing approach-related morbidity. Interlaminar and transforaminal approaches are complementary techniques; the choice of approach depends on the location, type, and morphology of the underlying pathology. The spectrum of indications primarily includes spinal compression syndromes such as disc herniations, central and lateral spinal canal stenosis, as well as discal and synovial facet joint cysts of the cervical, thoracic, and lumbar spine. Intradural pathologies are also amenable to endoscopic treatment. Furthermore, the use of endoscopic techniques for spinal fusion procedures has increased worldwide in recent years. The principal advantages include a further reduction in approach-related morbidity, minimal wound pain, and early patient mobilization. The risk of infection and wound-healing complications can be reduced to a minimum or virtually eliminated. Athletic patients, as well as elderly and multimorbid patients, benefit from the advantages of endoscopic surgery. The technique is particularly advantageous in obese patients, as these procedures can be performed largely independently of the patient’s body weight. Its principal limitation is the significant learning curve, which initially requires careful patient selection.