Overview of Tips in Overcoming Learning Curve in Uniportal and Biportal Endoscopic Spine Surgery

Abstract

There is increasing trend of spine surgeries performed with uniportal and biportal endoscopic spine surgery. Despite its good outcomes and supportive literature, the proportion of spine surgeons regularly doing endoscopic spine surgeries is relatively low. The main limitation is the steep learning curve in the early phase of endoscopic spine surgeries practice. There is paucity of literature in discussion of tips in overcoming these 2 schools of endoscopic spine surgery practice. In this tips and tricks overview, the authors highlights the key differences these 2 main school of endoscopic spine surgeries practice with specific discussions pertain-ing to “BIPORTALS”: the areas of basic medium of surgery, instruments for visualization and working, placement of portal(s), outflow of fluids, route of approach, technical challenges, anatomical challenges, location of lens and light source and start point to work. A ladder of progression of endoscopic spine surgery is proposed to effectively ease into the practice of endoscopic spine surgery.