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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Elsevier
2025-01-01
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| 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. |
| format | Article |
| id | doaj-art-795d33328cc742ada8e6fd8be7d38ab5 |
| institution | Kabale University |
| issn | 2772-5294 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| 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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