Essential Surgical Techniques During Fully Endoscopic Spine Surgery: A Historical Review and Future Perspectives

Full-endoscopic spine surgery (FESS) offers minimally invasive techniques for treating spinal le-sions with smaller incisions, leading to reduced tissue damage and consequently more rapid patient recovery. The essential techniques in FESS —namely, the transforaminal and interlaminar approaches—have evolved with technological advances in endoscopic systems and surgeon ex-pertise. The transforaminal approach consists of “inside-out” and “outside-in” techniques that have distinct applications depending on the patient’s condition. The interlaminar approach, sim-ilar to traditional spinal surgery techniques, is gaining wider acceptance due to its efficacy in addressing unique anatomical challenges. Advanced procedures, such as endoscopic laminecto-my and interbody fusion surgery, coupled with navigation systems, have broadened the scope of endoscopic spine surgery, making it an increasingly vital tool in modern spinal surgery.