A Historical Review of Endoscopic Spinal Discectomy

As an essential component of minimally invasive spine surgery, endoscopic spine surgery (ESS) has continuously evolved and has been accepted as a practical procedure by the worldwide spine community. Especially for lumbar disc herniation (LDH), the percutaneous endoscopic or full-endoscopic discectomy technique has been scientifically proven through randomized controlled trials and metaanalyses to be a good alternative to open discectomy. The initial concept of endoscopic spine discectomy was concerned with indirect disc decompression using various instruments such as blind forceps, a nucleotome, laser, radiofrequency coblation, and some chemical agents. The main surgical field has been shifted from the intradiscal space to the epidural space. Precise and selective discectomy for extruded LDH in the epidural space under high-quality endoscopic visualization is now feasible. Furthermore, the medical applications of ESS is broadening to include spinal stenosis, segmental instability, infection, and even intradural lesions. In this review article, I describe the history of endoscopic spine discectomy and decompression techniques, as well as evolution of the paradigm. This history may help indicate the future of practical ESS.

Automated summary

Endoscopic spine surgery (ESS) has evolved as an essential component of minimally invasive spine surgery, with percutaneous or full-endoscopic discectomy being a scientifically proven alternative for lumbar disc herniation. The surgical field has shifted from intradiscal space to epidural space, allowing for precise and selective discectomy. The medical applications of ESS are expanding to include various spinal conditions beyond disc herniation.