Overview and Prevention of Complications During Fully Endoscopic Lumbar Spine Surgery

Abstract

Fully endoscopic lumbar surgery has emerged as an alternative technique to classic open microscopic laminectomy or discectomy. It is gaining popularity due to its advantages in terms of minimal invasiveness, while achieving equivalent clinical outcomes. Remarkable technical developments in surgical techniques and instruments have expanded the indications of this surgical method. However, as the utilization of endoscopic surgery increases, related complications inevitably arise and become major clinical issues. Frequent complications include failure to achieve adequate decompression, early recurrence, and the possibility of wrong-level surgery. Intraoperative and perioperative complications can include postoperative sensory changes related to neural injury, dural tears, hematoma, infection, and rarely, water pressure-related problems. This review article presents an overview of the possible intraoperative and perioperative complications associated with uniportal full-endoscopic surgery. We also discuss the pitfalls that can lead to unexpected devastating results. Additionally, we briefly review potential preventive efforts that can help reduce the risks. The objective of this presentation is to reinforce the basic principles and introduce key technical tips for full-endoscopic spine surgery, ultimately leading to clinical success and the prevention of complications.