헤더 로고

JMISST Video Session Editor Chang Il Ju

This video article presents the challenges and efforts in addressing intradural lesions — a field that has long been considered a limitation of endoscopic spine surgery — and is expected to serve as a valuable reference for future developments in the field. By introducing endoscopy into intradural tumor removal, which was previously thought to be possible only with microscopic or open surgery, the indications for endoscopic surgery can be significantly expanded. Furthermore, the techniques described in this paper — including the Hopper cannula, Anastoclip, and two-hand technique — may serve as a foundation for the development of dedicated endoscopic surgical instruments.

In addition, the article is explained in a detailed, step-by-step manner, making it highly useful as an educational resource and likely to contribute to the creation of standardized surgical guidelines in the future.

This study goes beyond a simple technical report; it represents an important turning point that demonstrates the feasibility and safety of intradural lesion surgery using spinal endoscopy, supported by actual clinical cases and concrete techniques. It is a highly valuable piece of research that may contribute to expanding the indications of endoscopic spine surgery and establishing new standard surgical methods.

This video article is a technical note that introduces a novel transfacet approach for full endoscopic lumbar fusion surgery. It addresses the limitations of traditional techniques — such as the risk of nerve injury in the Kambin’s triangle approach and partial facet joint removal in the interlaminar approach — by enabling cage insertion while partially preserving the facet joint.

To simultaneously achieve two goals — reducing the risk of nerve injury and securing a stable path for cage insertion — the authors skillfully utilize the Harrison Cage Glider, ensuring both nerve protection and adequate disc space preparation during cage placement. The surgical procedure is systematically described from the initial skin incision to cannula insertion, drilling, cage placement, decompression, and screw fixation, accompanied by illustrations and videos, making it highly valuable for educational purposes.

Although full endoscopic lumbar interbody fusion is still perceived to be technically more demanding compared to UBE, this paper provides clear and detailed explanations that enable many surgeons to achieve successful outcomes using the uniportal technique.

This paper is a narrative review that comprehensively summarizes the clinical outcomes, technical challenges, and overcoming strategies of the full endoscopic transforaminal approach for lumbar foraminal stenosis (LFS) at the relatively demanding L5–S1 level. L5–S1 foraminal stenosis remains a challenging area not only for endoscopic surgery but also for open microsurgery, and the authors provide a meticulous analysis of the anatomical difficulties unique to this level.

By objectively and balancedly comparing fully endoscopic transforaminal foraminotomy (TELF) with other conventional surgical methods (such as the Wiltse approach and TLIF), the paper clearly presents both the advantages and limitations of TELF. Furthermore, it offers a detailed comparative analysis of various modified techniques (e.g., floating technique, outside-in-outside technique), incorporating objective clinical data such as postoperative dysesthesia (POD) rates, thereby enhancing the validity of its conclusions.

By citing a wide range of recent studies and surgical techniques, the paper effectively summarizes the current paradigm of endoscopic foraminal decompression surgery. It is expected to serve as a valuable reference for future surgeons who wish to take on the challenge of treating L5–S1 lumbar foraminal stenosis using the full endoscopic transforaminal approach.