{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T17:45:25Z","timestamp":1773769525334,"version":"3.50.1"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Epiduroscopy has emerged as a transformative minimally invasive tool for the diagnosis and treatment of spinal diseases. However, the infusion of irrigation fluids and manipulation of epidural structures during the procedure may unintentionally alter intracranial dynamics, leading to transient increases in intracranial pressure (ICP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This narrative review aims to evaluate the relationship between epiduroscopy and changes in optic nerve morphology, advocating for the use of ocular ultrasonography (OUS) as a non-invasive monitoring tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We consolidated contemporary literature regarding the pathophysiological foundations of optic nerve sheath diameter (ONSD) changes and the clinical utility of OUS during spinal interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ocular ultrasonography allows for real-time, bedside measurement of ONSD, which serves as a reliable indirect indicator of ICP. The optic nerve sheath, being continuous with the subarachnoid space, dilates in response to pressure surges transmitted from the epidural compartment during fluid irrigation. Studies have shown that dynamic monitoring of ONSD can guide intraoperative decisions, such as adjusting irrigation pressure or volume.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and future directions<\/jats:title>\n                    <jats:p>While OUS is currently subject to operator dependency, it provides a valuable non-invasive adjunct for identifying potential increases in ICP during epiduroscopy. Integrating ONSD evaluations into monitoring protocols may support clinical decision-making and enhance procedural vigilance. Future large-scale prospective studies are needed to establish standardized intervention thresholds and improve long-term patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1603586","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T14:40:55Z","timestamp":1773758455000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Optic nerve changes detected with ocular ultrasonography during epiduroscopy: a narrative review"],"prefix":"10.3389","volume":"13","author":[{"given":"\u0130lker","family":"\u00c7\u00f6ven","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Health and Science University Konya Training and Research Hospital","place":["Konya, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasin","family":"Tire","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Sciences","place":["Konya, T\u00fcrkiye"]},{"name":"Outcomes Research Consortium","place":["Houston, TX, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayd\u0131n","family":"Mermer","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Sciences","place":["Konya, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah","family":"Celep","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Sciences","place":["Konya, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serhat","family":"C\u00f6mert","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yildirim Beyazit University Yenimahalle Training and Research Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1111\/papr.12974","article-title":"Effectiveness of epiduroscopy for patients with failed back surgery syndrome: a systematic review and meta-analysis","volume":"21","author":"Geudeke","year":"2021","journal-title":"Pain Pract"},{"key":"B2","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1111\/j.1526-4637.2005.00062.x","article-title":"Visual impairment following epidural fluid injections and epiduroscopy: a review","volume":"6","author":"Gill","year":"2005","journal-title":"Pain Medicine"},{"key":"B3","doi-asserted-by":"publisher","first-page":"6911","DOI":"10.12659\/MSM.915708","article-title":"Assessment of optic nerve sheath diameter in patients undergoing epiduroscopy","volume":"25","author":"Tire","year":"2019","journal-title":"Med Sci Monit"},{"key":"B4","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1136\/bjophthalmol-2018-312934","article-title":"Ultrasonic measurement of optic nerve sheath diameter: a non-invasive surrogate approach for dynamic, real-time evaluation of intracranial pressure","volume":"103","author":"Chen","year":"2019","journal-title":"Br J Ophthalmol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1007\/s12028-011-9606-8","article-title":"Optic nerve ultrasound for the detection of raised intracranial pressure","volume":"15","author":"Rajajee","year":"2011","journal-title":"Neurocrit Care"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1284","DOI":"10.1007\/s00134-018-5305-7","article-title":"Optic nerve sheath diameter measured sonographically as non-invasive estimator of intracranial pressure: a systematic review and meta-analysis","volume":"44","author":"Robba","year":"2018","journal-title":"Intensive Care Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"3589762","DOI":"10.1155\/2018\/3589762","article-title":"New optic nerve sonography quality criteria in the diagnostic evaluation of traumatic brain injury","volume":"2018","author":"Soliman","year":"2018","journal-title":"Crit Care Res Pract"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1055\/s-2003-37962","article-title":"Endoscopic surgery of the lumbar epidural space (epiduroscopy): results of therapeutic intervention in 93 patients","volume":"46","author":"Ruetten","year":"2003","journal-title":"Minim Invasive Neurosurg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1111\/j.1533-2500.2012.00549.x","article-title":"Diagnosis of the vertebral level from which low back or leg pain originates. 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