{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T08:30:53Z","timestamp":1793349053132,"version":"4.5.0"},"reference-count":0,"publisher":"Korean Neurosurgical Society","issue":"6","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"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":[[2026,11,1]]},"abstract":"<jats:p>Uniportal full-endoscopic spine surgery (FESS) has expanded over three decades from percutaneous discectomy to include multilevel decompression, endoscopic interbody fusion (Endo-LIF), spinal infection management, and tumor surgery. The Republic of Korea is a leading contributor to this field : across bibliometric analyses, six of the world\u2019s top 10 contributing authors and three of the top five contributing institutions are Korean. This article provides a Korea-centered critical appraisal of uniportal FESS, integrating five domains : Korean academic contributions, Level-I evidence by spinal region, expansion of indications, integration of next-generation technologies (navigation, augmented reality, artificial intelligence, robotics), and structural barriers in health policy and reimbursement. Level-I randomized evidence supports clinical equivalence to microscopic surgery for lumbar disc herniation and lumbar spinal stenosis, with cost-utility data from the Korean National Health Insurance Service showing a cost-per-quality-adjusted-life-year of approximately USD 5241\u2014well below conventional willingness-to-pay thresholds. Cervical FESS evidence remains limited to two single-center randomized controlled trials from 2008\u20132009, and thoracic FESS data derive from non-randomized multicenter case series showing large perioperative advantages over open surgery. Despite the maturity of the evidence, Korean reimbursement codes have not been updated to reflect modern uniportal techniques, Endo-LIF lacks dedicated coding, and the radiofrequency-related fee schedule still uses 1990s-era valuations. We propose a tiered policy roadmap\u2014short-term code differentiation, mid-term Endo-LIF and navigation-track integration, and long-term registry-based credentialing\u2014to align Korean reimbursement infrastructure with the country\u2019s established academic and clinical leadership in this field.<\/jats:p>","DOI":"10.3340\/jkns.2026.0214","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T06:33:51Z","timestamp":1788244431000},"page":"836-854","update-policy":"https:\/\/doi.org\/10.3340\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Evolution and Global Impact of Uniportal Endoscopic Spine Surgery : A Korean Perspective and Historical Legacy"],"prefix":"10.3340","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5086-0875","authenticated-orcid":true,"given":"Jin-Sung","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1892","container-title":["Journal of Korean Neurosurgical Society"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/jkns.or.kr\/upload\/pdf\/jkns-2026-0214.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/jkns.or.kr\/journal\/view.php?doi=10.3340\/jkns.2026.0214","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/jkns.or.kr\/upload\/pdf\/jkns-2026-0214.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T07:42:14Z","timestamp":1793346134000},"score":1,"resource":{"primary":{"URL":"http:\/\/jkns.or.kr\/journal\/view.php?doi=10.3340\/jkns.2026.0214"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11,1]]},"references-count":0,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"URL":"https:\/\/doi.org\/10.3340\/jkns.2026.0214","relation":{},"ISSN":["2005-3711","1598-7876"],"issn-type":[{"value":"2005-3711","type":"print"},{"value":"1598-7876","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,11,1]]},"assertion":[{"value":"2026-07-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-01","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-11-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}