Full-endoscopic spine surgery for intradural pathologies: A systematic review of innovations, challenges, and future prospects

Introduction: Full-endoscopic spinal surgery (monoportal endoscopy) has emerged as a minimally invasive alternative for managing intradural spinal pathologies, offering reduced morbidity and accelerated recovery compared to conventional techniques. Research question: What is the current evidence on...

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Main Authors: Ilyas Dolas, Tugrul Cem Unal, Cafer Ikbal Gulsever, Duygu Dolen, Ali Guven Yorukoglu, Altay Sencer
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Brain and Spine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772529425002115
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author Ilyas Dolas
Tugrul Cem Unal
Cafer Ikbal Gulsever
Duygu Dolen
Ali Guven Yorukoglu
Altay Sencer
author_facet Ilyas Dolas
Tugrul Cem Unal
Cafer Ikbal Gulsever
Duygu Dolen
Ali Guven Yorukoglu
Altay Sencer
author_sort Ilyas Dolas
collection DOAJ
description Introduction: Full-endoscopic spinal surgery (monoportal endoscopy) has emerged as a minimally invasive alternative for managing intradural spinal pathologies, offering reduced morbidity and accelerated recovery compared to conventional techniques. Research question: What is the current evidence on the effectiveness, limitations, and future prospects of full-endoscopic spinal surgery for intradural pathologies? Material and methods: A systematic review following PRISMA guidelines was conducted. Electronic databases (Cochrane, OVID-MEDLINE, PubMed, Embase, Web of Science, Scopus) were searched for studies published from 2000 to 2024. Studies on full-endoscopic intradural spine surgery, including clinical trials, comparative studies, case reports, and meta-analyses in English, were included. Exclusion criteria involved non-intradural pathologies, biportal techniques, animal studies, and non-English publications. Narrative synthesis was performed due to study heterogeneity. Results: Thirty studies were reviewed. Full-endoscopic techniques effectively managed conditions such as tethered cord syndrome, spinal arachnoid cysts, intradural extramedullary tumors, Chiari malformation, and select vascular and inflammatory conditions. Benefits included minimal tissue disruption, improved visualization, shorter hospital stays, and reduced complications. Key challenges identified were intraoperative bleeding control, reliable dural closure, and irrigation-related complications like increased intracranial pressure. Discussion and conclusion: Full-endoscopic spine surgery demonstrates substantial clinical promise for intradural spinal conditions, significantly reducing morbidity and enhancing recovery. However, addressing current technical challenges is essential. Ongoing technological advancements in imaging, neuronavigation, and robotic-assisted systems, combined with future clinical trials, will be critical for expanding indications and confirming long-term efficacy.
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spelling doaj-art-795d33328cc742ada8e6fd8be7d38ab52025-08-20T04:02:51ZengElsevierBrain and Spine2772-52942025-01-01510439210.1016/j.bas.2025.104392Full-endoscopic spine surgery for intradural pathologies: A systematic review of innovations, challenges, and future prospectsIlyas Dolas0Tugrul Cem Unal1Cafer Ikbal Gulsever2Duygu Dolen3Ali Guven Yorukoglu4Altay Sencer5Department of Neurosurgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyDepartment of Neurosurgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyDepartment of Neurosurgery, Hakkari State Hospital, Hakkari, Turkey; Corresponding author.Department of Neurosurgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyDepartment of Neurosurgery, Istanbul Scoliosis and Spine Center, Florence Nightingale Hospital, Istanbul, TurkeyDepartment of Neurosurgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyIntroduction: Full-endoscopic spinal surgery (monoportal endoscopy) has emerged as a minimally invasive alternative for managing intradural spinal pathologies, offering reduced morbidity and accelerated recovery compared to conventional techniques. Research question: What is the current evidence on the effectiveness, limitations, and future prospects of full-endoscopic spinal surgery for intradural pathologies? Material and methods: A systematic review following PRISMA guidelines was conducted. Electronic databases (Cochrane, OVID-MEDLINE, PubMed, Embase, Web of Science, Scopus) were searched for studies published from 2000 to 2024. Studies on full-endoscopic intradural spine surgery, including clinical trials, comparative studies, case reports, and meta-analyses in English, were included. Exclusion criteria involved non-intradural pathologies, biportal techniques, animal studies, and non-English publications. Narrative synthesis was performed due to study heterogeneity. Results: Thirty studies were reviewed. Full-endoscopic techniques effectively managed conditions such as tethered cord syndrome, spinal arachnoid cysts, intradural extramedullary tumors, Chiari malformation, and select vascular and inflammatory conditions. Benefits included minimal tissue disruption, improved visualization, shorter hospital stays, and reduced complications. Key challenges identified were intraoperative bleeding control, reliable dural closure, and irrigation-related complications like increased intracranial pressure. Discussion and conclusion: Full-endoscopic spine surgery demonstrates substantial clinical promise for intradural spinal conditions, significantly reducing morbidity and enhancing recovery. However, addressing current technical challenges is essential. Ongoing technological advancements in imaging, neuronavigation, and robotic-assisted systems, combined with future clinical trials, will be critical for expanding indications and confirming long-term efficacy.http://www.sciencedirect.com/science/article/pii/S2772529425002115Full-endoscopic spine surgeryIntradural extramedullary tumorsIntradural pathologiesMinimally invasive neurosurgerySpinal arachnoid cystsTethered cord syndrome
spellingShingle Ilyas Dolas
Tugrul Cem Unal
Cafer Ikbal Gulsever
Duygu Dolen
Ali Guven Yorukoglu
Altay Sencer
Full-endoscopic spine surgery for intradural pathologies: A systematic review of innovations, challenges, and future prospects
Brain and Spine
Full-endoscopic spine surgery
Intradural extramedullary tumors
Intradural pathologies
Minimally invasive neurosurgery
Spinal arachnoid cysts
Tethered cord syndrome
title Full-endoscopic spine surgery for intradural pathologies: A systematic review of innovations, challenges, and future prospects
title_full Full-endoscopic spine surgery for intradural pathologies: A systematic review of innovations, challenges, and future prospects
title_fullStr Full-endoscopic spine surgery for intradural pathologies: A systematic review of innovations, challenges, and future prospects
title_full_unstemmed Full-endoscopic spine surgery for intradural pathologies: A systematic review of innovations, challenges, and future prospects
title_short Full-endoscopic spine surgery for intradural pathologies: A systematic review of innovations, challenges, and future prospects
title_sort full endoscopic spine surgery for intradural pathologies a systematic review of innovations challenges and future prospects
topic Full-endoscopic spine surgery
Intradural extramedullary tumors
Intradural pathologies
Minimally invasive neurosurgery
Spinal arachnoid cysts
Tethered cord syndrome
url http://www.sciencedirect.com/science/article/pii/S2772529425002115
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