Endoscopic spine discectomy: indications and outcomes

Percutaneous endoscopic discectomy is an effective minimally invasive spine surgery (MISS) for soft disc herniations. The objective of this review was to describe the current indications, surgical techniques, and clinical outcomes of endoscopic spine surgery. A narrative review was performed with a focus on surgical indication of percutaneous endoscopic discectomy and the clinical outcomes in lumbar and cervical spine. Percutaneous endoscopic or full-endoscopic discectomy using a working channel endoscope was described. The basic principles, surgical techniques, and clinical outcomes in lumbar and cervical disc herniations were demonstrated. For the lumbar disc herniation (LDH), transforaminal and interlaminar approaches were reviewed, whereas for the cervical disc herniation (CDH), anterior and posterior approaches were reviewed. Endoscopic spine surgery for soft disc herniation can be effective with benefits of minimal tissue trauma in properly selected cases. Given the recent technical advancements, the surgical indications for endoscopic spine surgery are still expanding and the clinical results have become more practical and reliable.