{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:54:45Z","timestamp":1791910485287,"version":"4.3.4"},"reference-count":124,"publisher":"Korean Neurosurgical Society","issue":"5","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["jkns.or.kr"],"crossmark-restriction":true},"short-container-title":["J Korean Neurosurg Soc"],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:p>Endoscopic spine surgery is the perfect culmination of the concept of minimally invasive spine surgery. Among the various endoscopic spine procedures, full-endoscopic spine surgery (FESS) is an endoscopic technique characterized by the performance of the entire spinal procedure via the percutaneous approach using a uniportal working-channel endoscope with continuous saline perfusion. FESS effectively decompresses the tissues and allows for instrumentation while preserving the normal musculoskeletal structures. It also has fewer complications and enables quicker return to work. However, potential disadvantages include its steep learning curves and limited indications. Previously, the indications for endoscopic procedures had been limited to soft disc herniations or focal neural impingement, with most degenerative spinal diseases other than disc herniation being considered contraindications. However, owing to the remarkable advancements in endoscopic technology, nearly all degenerative spinal diseases, including spinal stenosis and instability, can currently be treated using FESS. Furthermore, the application of spinal endoscopes has expanded to other spinal disorders, including infections, traumas, and tumors. Unfortunately, the steep learning curve and technical limitations of FESS cannot be overlooked by most standard spine surgeons. To ensure the clinical success of endoscopic procedures in actual clinical practice, a comprehensive understanding of the core properties of working channel endoscopes is necessary to facilitate the learning process. With the ongoing development of endoscopic technology, endoscopic surgery can be expected to become the standard treatment approach for all degenerative spinal diseases in the near future.<\/jats:p>","DOI":"10.3340\/jkns.2024.0227","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T19:08:44Z","timestamp":1746731324000},"page":"511-527","update-policy":"https:\/\/doi.org\/10.3340\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Full-Endoscopic Spine Surgery : Its Roles and Limitations"],"prefix":"10.3340","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3262-1672","authenticated-orcid":true,"given":"Yong","family":"Ahn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1892","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.14245\/ns.2346118.059"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2020.1853523"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.01.209"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9020371"},{"key":"ref5","first-page":"617","volume-title":"Radiation exposure to the surgeon during percutaneous endoscopic lumbar discectomy: a prospective study","author":"Ahn","year":"2013"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-010-1493-8"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2023.2214678"},{"key":"ref8","first-page":"124","volume-title":"Percutaneous endoscopic lumbar foraminotomy: an advanced surgical technique and clinical outcomes","author":"Ahn","year":"2014"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-05866-2"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2020.02.043"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.14245\/ns.2244294.147"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3171\/2019.6.spine19532"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2013\/16\/335"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2023.05.012"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000216431.69359.91"},{"key":"ref16","first-page":"E1191","volume-title":"Transforaminal versus interlaminar approach of full-endoscopic lumbar discectomy under local anesthesia for L5\/S1 disc herniation: a randomized controlled trial","author":"Chen","year":"2022"},{"key":"ref17","first-page":"278","volume-title":"Percutaneous microdecompressive endoscopic cervical discectomy with laser thermodiskoplasty","author":"Chiu","year":"2000"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1287774"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-015-2670-7"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-013-2849-7"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1246159"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-015-3776-6"},{"key":"ref23","first-page":"1154","volume-title":"Intraoperative neurophysiological monitoring in spine surgery: a systematic review and meta-analysis","author":"Daniel","year":"2018"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1007\/s00132-018-3528-5"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/s0090-3019(98)00004-4"},{"key":"ref26","first-page":"E87","volume-title":"Pain-free survival after endoscopic rhizotomy versus radiofrequency for lumbar facet joint pain: a real-world comparison study","author":"Du","year":"2022"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.surneu.2008.10.005"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.4103\/2152-7806.196764"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.3171\/2015.7.spine15304"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1592157"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2014.10.025"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.3171\/foc.1999.7.5.8"},{"key":"ref33","first-page":"538","volume-title":"Percutaneous transforaminal endoscopic discectomy versus open microdiscectomy for lumbar disc herniation: a systematic review and metaanalysis","author":"Gadjradj","year":"2021"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-016-4885-6"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.14444\/1028"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/8419739"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-023-01989-6"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199907000-00008"},{"key":"ref39","first-page":"9","volume-title":"Percutaneous nucleotomy. A new concept technique and 12 years\u2019 experience","author":"Hijikata","year":"1989"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1177\/2192568219887364"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000245955.22358.3a"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-012-2540-4"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-021-05042-4"},{"key":"ref44","first-page":"e15541","volume-title":"Full-endoscopic interlaminar discectomy for the treatment of a dorsal migrated thoracic disc herniation: case report","author":"Hur","year":"2019"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2012.06.018"},{"key":"ref46","first-page":"389","volume-title":"Spine update. Lumbar foraminal stenosis","author":"Jenis","year":"2000"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.3791\/65456"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2020.105948"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.12.095"},{"key":"ref50","first-page":"297","volume-title":"Removal of a vertebral metastatic tumor compressing the spinal nerve roots via a single-port, transforaminal, endoscopic approach under monitored anesthesia care","author":"Joo","year":"2012"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.14245\/ns.2346226.113"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1996.84.3.0462"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199802000-00018"},{"key":"ref54","first-page":"37","volume-title":"Posterolateral percutaneous suction-excision of herniated lumbar intervertebral discs. Report of interim results","author":"Kambin","year":"1986"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.36076\/ppj\/2019.22.75"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-200211002-00020"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2009.24.2.302"},{"key":"ref58","first-page":"123","volume-title":"Comparison of multifidus muscle atrophy and trunk extension muscle strength: percutaneous versus open pedicle screw fixation","author":"Kim","year":"2005"},{"key":"ref59","doi-asserted-by":"publisher","DOI":"10.3791\/57999"},{"key":"ref60","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2009.45.3.192"},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2022.0140"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2022.04.130"},{"key":"ref63","first-page":"281","volume-title":"Bilateral operation of lumbar degenerative central spinal stenosis in full-endoscopic interlaminar technique with unilateral approach: prospective 2-year results of 74 patients","author":"Komp","year":"2011"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.36076\/ppj\/2015.18.61"},{"key":"ref65","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-023-07678-5"},{"key":"ref66","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2017.06.11"},{"key":"ref67","doi-asserted-by":"publisher","DOI":"10.14245\/ns.2346236.118"},{"key":"ref68","doi-asserted-by":"publisher","DOI":"10.14245\/ns.1938048.024"},{"key":"ref69","doi-asserted-by":"publisher","DOI":"10.2176\/nmc.48.383"},{"key":"ref70","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnv120"},{"key":"ref71","doi-asserted-by":"publisher","DOI":"10.14444\/6008"},{"key":"ref72","doi-asserted-by":"publisher","DOI":"10.1177\/21925682211020696"},{"key":"ref73","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-58198-x"},{"key":"ref74","first-page":"103","volume-title":"Full-endoscopic procedures versus traditional discectomy surgery for discectomy: a systematic review and meta-analysis of current global clinical trials","author":"Li","year":"2016"},{"key":"ref75","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-5527-y"},{"key":"ref76","doi-asserted-by":"publisher","DOI":"10.14245\/ns.2040196.098"},{"key":"ref77","doi-asserted-by":"publisher","DOI":"10.21182\/jmisst.2023.00906"},{"key":"ref78","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.12.180"},{"key":"ref79","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1993.78.2.0216"},{"key":"ref80","doi-asserted-by":"publisher","DOI":"10.1007\/bf00258242"},{"key":"ref81","doi-asserted-by":"publisher","DOI":"10.14444\/7010"},{"key":"ref82","doi-asserted-by":"publisher","DOI":"10.14444\/8209"},{"key":"ref83","doi-asserted-by":"publisher","DOI":"10.1016\/s1935-9810(07)70054-3"},{"key":"ref84","first-page":"1599","volume-title":"Postoperative magnetic resonance imaging of lumbar disc herniation: comparison of microendoscopic discectomy and Love\u2019s method","author":"Muramatsu","year":"2001"},{"key":"ref85","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-009-1155-x"},{"key":"ref86","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsp.2012.04.001"},{"key":"ref87","doi-asserted-by":"publisher","DOI":"10.1016\/j.nec.2006.06.002"},{"key":"ref88","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-200211002-00018"},{"key":"ref89","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2016.05.061"},{"key":"ref90","first-page":"31","volume-title":"Decompression of lumbar lateral spinal stenosis: full-endoscopic, interlaminar technique","author":"Ruetten","year":"2013"},{"key":"ref91","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-008-0684-y"},{"key":"ref92","first-page":"940","volume-title":"Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study","author":"Ruetten","year":"2008"},{"key":"ref93","first-page":"931","volume-title":"Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study","author":"Ruetten","year":"2008"},{"key":"ref94","first-page":"122","volume-title":"Recurrent lumbar disc herniation after conventional discectomy: a prospective, randomized study comparing full-endoscopic interlaminar and transforaminal versus microsurgical revision","author":"Ruetten","year":"2009"},{"key":"ref95","doi-asserted-by":"publisher","DOI":"10.3171\/2008.7.17634"},{"key":"ref96","doi-asserted-by":"publisher","DOI":"10.1007\/s005860100315"},{"key":"ref97","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.01.206"},{"key":"ref98","doi-asserted-by":"publisher","DOI":"10.14245\/ns.2346508.254"},{"key":"ref99","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-5656-3"},{"key":"ref100","doi-asserted-by":"publisher","DOI":"10.3171\/case24413"},{"key":"ref101","doi-asserted-by":"publisher","DOI":"10.3171\/spi-08\/01\/017"},{"key":"ref102","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2015.03.022"},{"key":"ref103","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2004.01.014"},{"key":"ref104","first-page":"41","volume-title":"Transforaminal endoscopic decompression for radiculopathy secondary to intracanal noncontained lumbar disc herniations: outcome and technique","author":"Tsou","year":"2002"},{"key":"ref105","doi-asserted-by":"publisher","DOI":"10.1177\/2192568219878131"},{"key":"ref106","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2016.02.086"},{"key":"ref107","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2013.06.008"},{"key":"ref108","first-page":"e8640","volume-title":"Transforaminal endoscopy in lumbar burst fracture: a case report","author":"Wang","year":"2017"},{"key":"ref109","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200003010-00013"},{"key":"ref110","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.10.061"},{"key":"ref111","first-page":"E379","volume-title":"Complications of lumbar disc herniation following full-endoscopic interlaminar lumbar discectomy: a large, single-center, retrospective study","author":"Xie","year":"2017"},{"key":"ref112","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-022-07470-x"},{"key":"ref113","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000000508"},{"key":"ref114","doi-asserted-by":"publisher","DOI":"10.1177\/2309499019863356"},{"key":"ref115","doi-asserted-by":"publisher","DOI":"10.14245\/ns.2244600.300"},{"key":"ref116","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-010-1642-0"},{"key":"ref117","first-page":"722","volume-title":"Posterolateral endoscopic excision for lumbar disc herniation: surgical technique, outcome, and complications in 307 consecutive cases","author":"Yeung","year":"2002"},{"key":"ref118","first-page":"e20709","volume-title":"Transforaminal approach versus interlaminar approach: a meta-analysis of operative complication of percutaneous endoscopic lumbar discectomy","author":"Yin","year":"2020"},{"key":"ref119","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-5521-4"},{"key":"ref120","doi-asserted-by":"publisher","DOI":"10.3171\/2019.12.jns192600"},{"key":"ref121","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2020.01.04"},{"key":"ref122","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-018-0868-0"},{"key":"ref123","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1193311"},{"key":"ref124","first-page":"E105","volume-title":"Unique complications of percutaneous endoscopic lumbar discectomy and percutaneous endoscopic interlaminar discectomy","author":"Zhou","year":"2018"}],"container-title":["Journal of Korean Neurosurgical Society"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/jkns.or.kr\/upload\/pdf\/jkns-2024-0227.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/jkns.or.kr\/journal\/view.php?doi=10.3340\/jkns.2024.0227","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/jkns.or.kr\/upload\/pdf\/jkns-2024-0227.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T05:52:10Z","timestamp":1756965130000},"score":1,"resource":{"primary":{"URL":"http:\/\/jkns.or.kr\/journal\/view.php?doi=10.3340\/jkns.2024.0227"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,1]]},"references-count":124,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,9]]}},"URL":"https:\/\/doi.org\/10.3340\/jkns.2024.0227","relation":{},"ISSN":["2005-3711","1598-7876"],"issn-type":[{"value":"2005-3711","type":"print"},{"value":"1598-7876","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,1]]},"assertion":[{"value":"2024-12-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-08","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}