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for the increased probability of DiGeorge syndrome. For second-tier testing, comparative genome hybridization or multiplex ligation-dependent probe amplification are recommended to identify atypical microdeletions. Newborns with DiGeorge syndrome require special care in perinatal intensive centers including pediatric cardiology and genetic counseling. Orv Hetil. 2022; 163(1) 21-30.

Endoscopic spine surgery in the cervicothoracic spine is generating continued interest in a rapidly evolving field. The authors present 4 techniques for fully endoscopic cervical spine surgery (1) posterior cervical unilateral laminectomy and bilateral decompression, (2) posterior cervical foraminotomy, (3) anterior cervical discectomy, and (4) anterior transcorporal discectomy. Two techniques for fully endoscopic thoracic spine surgery are also presented (1) posterior thoracic unilateral laminectomy and bilateral decompression and (2) transforaminal thoracic endoscopic discectomy and foraminotomy.

We describe 6 different surgical approaches and review the relevant literature about each technique.

The clinical application of endoscopic spine surgery techniques has evolved over the past 40 years. Recent data suggest comparable outcomes to other procedures and perhaps fewer complications and quicker recovery when these techniques are used in the cervical and thoracic spine. Significant variability exists in these approaches depending on the goal of canal decompression, root decompression, and the site of the pathology.

Each endoscopic approach in the cervicothoracic spine has its technical nuances, outcomes, advantages, and disadvantages, making fully endoscopic cervicothoracic spine surgery an exciting and growing field.

Each endoscopic approach in the cervicothoracic spine has its technical nuances, outcomes, advantages, and disadvantages, making fully endoscopic cervicothoracic spine surgery an exciting and growing field.Uniportal endoscopic lumbar interbody fusion aims to achieve the bony union of 2 lumbar segments through cage insertion using full spinal endoscopy. Endoscopic fusion can adjust foraminal height and disc height, improve alignment, and minimize collateral soft tissue damage during the insertion of an interbody cage. The surgery is performed under constant irrigation with normal saline and an optical endoscopic lens close to the targeted disc segment. Two main subtypes of uniportal endoscopic fusion are currently described in the literature. We broadly classify them into facet-preserving and facet-sacrificing endoscopic lumbar interbody fusions. We have termed them uniportal facet-preserving trans-Kambin endoscopic fusion and uniportal facet-sacrificing posterolateral transforaminal lumbar interbody fusion. In this article, we review the current literature and discuss the history, indications, contraindications, technical differences, clinical outcomes, and complications of uniportal endoscopic interbody fusion surgery.

From the 1990s, there has been growth in the literature demonstrating the feasibility of minimally invasive approaches for treating variety lumbar spinal disorders. There is still much work to be done in overcoming the technical challenges and explicate relative advantages of endoscopic techniques in lumbar spine surgery. In this comprehensive literature review, we discuss the history, indications, contraindications, surgical techniques, learning curves, technical tips, adverse events, and examine peer-reviewed studies addressing uniportal endoscopic interlaminar decompression in lumbar spinal surgery.

This literature review was conducted with keywords “endoscopic,” “minimally invasive,” “uniportal endoscopic decompression,” “interlaminar decompression,” and “lumbar spinal surgery” using PubMed, Embase, ClinicalKey, and Google Scholar.

Review of 423 patients who underwent uniportal endoscopic interlaminar lumbar decompression showed satisfying results with 82% of patients no longer having leg pain, and % lower chance of having complications compared with those receiving microscopic decompression in lumbar stenosis.

Based on our literature review, there are multiple positive outcomes with endoscopic interlaminar lumbar decompression, which reduces operation duration, perioperative complications, and better postoperative outcomes. However, the technical challenge highlights the importance of further training and innovation in this rapidly evolving field.

Based on our literature review, there are multiple positive outcomes with endoscopic interlaminar lumbar decompression, which reduces operation duration, perioperative complications, and better postoperative outcomes. However, the technical challenge highlights the importance of further training and innovation in this rapidly evolving field.

When pain caused by lumbar disc herniation (LDH) is not relieved after 4 to 6 weeks of conservative treatment, surgery is recommended. Open microdiscectomy is a standard surgical technique, but surgical endoscopy enables endoscopic lumbar surgery with clinical outcomes similar to those of standard microdiscectomy. Endoscopic lumbar discectomy is largely divided into transforaminal endoscopic lumbar discectomy (TELD) and interlaminar endoscopic lumbar discectomy (IELD). TELD was introduced about 10 years earlier than IELD and seems to be more popular than IELD.

The present article reviews the surgical technique, indications, and outcomes of IELD. Although much is still unknown, potential future perspectives are reviewed.

Although improved surgical techniques enable TELD to be versatile, IELD is still specifically beneficial for patients with highly migrated LDH and a high iliac crest. Selleckchem Aminocaproic There is a large body of literature indicating favorable outcomes with both TELD and IELD. Currently, the selection of TEurgical robots, and artificial reality, and a precise and systematic approach to decision-making and surgical techniques is required to combine these technologies effectively.

Open microdiscectomy is the gold standard surgical technique for radiculopathy with lumbar disc herniation (LDH). Transforaminal endoscopic lumbar discectomy (TELD) has been developed as an effective and minimally invasive alternative to open surgery. As a result of these remarkable technical evolutions, the clinical outcomes of TELD have become comparable to those of conventional open surgery. However, considerable learning curves and endoscopy-related adverse events may emerge as critical problems.

The objective of this article was to inform on the basic principles, surgical techniques, and keys to clinical success in preventing complications.

A narrative review of the literature focused on the surgical indications, technical tips, complications, and learning curve of the full-endoscopic procedure was performed.

First, the transforaminal endoscopic system should access as close as possible to the target point, avoiding exiting nerve root irritation. Second, selective removal of the herniated disc frfull-endoscopic transforaminal discectomy technique for soft LDH is an effective alternative with the benefits of minimally invasive surgery in appropriately selected patients. Given recent technical developments, the surgical indications for TELD will be broader and the clinical outcomes will be more reliable.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.The goal of a spine surgery is to achieve adequate neural tissue decompression, maintenance of spinal stability, and successful stabilization of an unstable spine. To achieve these surgical goals, damage to normal tissues, including the spinal column and surrounding soft tissues, is inevitable after the beginning of a spine surgery. Extensive damage to normal spinal column and paraspinal collateral tissues during operation can lead to unsuccessful outcomes due to persistent axial pain and additional surgeries due to occurrence of spinal instability. Numerous efforts, such as the usage of microscopy, tubular retractor systems, percutaneous instruments, and trials of new operative approaches have been attempted to reduce normal tissue damage and improve surgical outcomes. Endoscopic spine surgery (ESS) was introduced about 3 decades ago as a minimally invasive spine surgery and has been widely spread with the development of endoscopic surgical instruments and adoption of new endoscopic surgical approaches during the past 2 decades. Theoretically, ESS may be the gold standard method of spine surgery because of its minimal tissue damage and good visualization of the surgical field. However, surgeons hesitate to initiate an ESS due to its steep learning curve and the lack of high-level evidence of surgical outcomes. In this article, the rationale and advantages of performing ESS are discussed by reviewing published articles.Throughout its evolution, spine surgery has migrated toward less invasiveness. For posterior lumbar surgery, percutaneous techniques together with endoscopic visualization allow for the smallest surgical corridor. Initially, this approach utilized the natural entry point into the spinal canal via the transforaminal approach via Kamin’s triangle. The interlaminar endoscopic technique was subsequently developed to address central disc herniations at L5-S1, where the transforaminal approach can be challenging to reach the surgical pathology. More recently, the dual portal posterior lumbar endoscopic technique provides for yet another method of performing posterior lumbar surgery, expanding its versatility, including the treatment of spinal stenosis. In addition to treating disc pathology, percutaneous endoscopic lumbar interbody fusions are now performed in select patients in the ambulatory surgery setting. Despite the dramatic advantages of advanced minimally invasive procedures, the adoption of endoscopic spine surgery in everyday practice has lagged. The main obstacle to adoption appears to be the difficult learning curve of endoscopic surgery combined with the fact that traditional microdiscectomy surgery remains one of the most successful operations in our treatment armamentarium. The successful future of endoscopic spine surgery will depend on our ability to address the learning curve problem. In the future, this problem may be addressed through the use to computer-assisted navigation, robotic assistance, and an integrated operating room suite that improves the efficiencies and ergonomics of increasingly complex surgical treatment strategies.