PT  - JOURNAL ARTICLE
AU  - Lewandrowski, Kai-Uwe
AU  - Telfeian, Albert E.
AU  - Hellinger, Stefan
AU  - Jorge Felipe Ramírez León,
AU  - Paulo Sérgio Teixeira de Carvalho,
AU  - Ramos, Max R.F.
AU  - Kim, Hyeun Sung
AU  - Hanson, Daniel W.
AU  - Salari, Nimar
AU  - Yeung, Anthony
TI  - Difficulties, Challenges, and the Learning Curve of Avoiding Complications in Lumbar Endoscopic Spine Surgery
AID  - 10.14444/8161
DP  - 2021 Dec 01
TA  - International Journal of Spine Surgery
PG  - S21--S37
VI  - 15
IP  - suppl 3
4099  - https://www.ijssurgery.com/content/15/suppl_3/S21.short
4100  - https://www.ijssurgery.com/content/15/suppl_3/S21.full
SO  - Int J Spine Surg2021 Dec 01; 15
AB  - Spinal endoscopy has the stigma of being reserved for only a few surgeons who can figure out how to master the steep learning curve and develop clinical practice settings where endoscopic spine surgery can thrive. In essence, endoscopic treatment of herniated discs specifically and nerve root compression in the lumbar spine in general amounts to replacing traditional open spine surgery protocols with spinal endoscopic surgery techniques. In doing so, the endoscopic spine surgeon must be confident that the degenerative spine's common painful problems can be handled with endoscopic spinal surgery techniques with at least comparable clinical results and complication rates. In this review article, the authors illustrate the difficulties and challenges of the endoscopic lumbar decompression procedure. In addition, they shed light on how to master the learning curve by systematically looking at all sides of the problem, ranging from the ergonomic aspects of the endoscopic platform and its instruments, surgical access planning, challenging clinical scenarios, complications, and sequelae, as well as the training gaps after postgraduate residency and fellowship programs.