Classification of endoscopic spine procedures
ABSTRACT: Background: A consensus on grading the complexity of endoscopic spinal procedures is lacking, but urgently needed to guide training, clinical practice, and regulatory concepts. Methods: A 2-dimensional classification system was developed, considering both the technical and morphological p...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-06-01
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| Series: | North American Spine Society Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S266654842500023X |
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| author | Mazda Farshad, MD Christoph J. Laux, MD Florian Wanivenhaus, MD José M. Spirig, MD Jonas Widmer, PhD Michael Kelly, MD Javier Quillo-Olvera, MD Jin-Sung Kim, MD Facundo van Isseldyk, MD Sohrab Gollogly, MD James Yue, MD Xuexiao Ma, MD Vincent Hagel, MD Frédéric Cornaz, MD |
| author_facet | Mazda Farshad, MD Christoph J. Laux, MD Florian Wanivenhaus, MD José M. Spirig, MD Jonas Widmer, PhD Michael Kelly, MD Javier Quillo-Olvera, MD Jin-Sung Kim, MD Facundo van Isseldyk, MD Sohrab Gollogly, MD James Yue, MD Xuexiao Ma, MD Vincent Hagel, MD Frédéric Cornaz, MD |
| author_sort | Mazda Farshad, MD |
| collection | DOAJ |
| description | ABSTRACT: Background: A consensus on grading the complexity of endoscopic spinal procedures is lacking, but urgently needed to guide training, clinical practice, and regulatory concepts. Methods: A 2-dimensional classification system was developed, considering both the technical and morphological parameters contributing to the complexity of endoscopic spine procedures. An international survey with 68 questions - including those on demographic data and surgical volumes, suitability of the proposed 2-dimensional classification system, and categories of techniques and morphologies - was completed by spine surgeons with endoscopic experience. A consensus was defined as a difference >/= 10% between the most frequently given grade and the second most given grade. In cases of no clear consensus (ie, agreement of less than 10%), an additional analysis considering only the responses from surgeons with experience of more than 500 endoscopic spine surgeries was performed. Results: 115 survey entries were received, of which 112 were analyzed. The participating spine surgeons (64% orthopedic surgeons, 35% neurosurgeons, 1% other) originated from 27 countries and have performed an average of 509 endoscopic spine surgeries (55,984 total endoscopic procedures). 85.7% of the survey respondents agreed that the proposed 2-dimensional classification system was indeed appropriate for its particular purpose. Thus, a consensus classification system was born, allowing for grading simple procedures (eg, Ia for lumbar interlaminar discectomy of a soft disc herniation) to complex procedures (eg, IIIc for revision posterior endoscopic cervical central decompression). Conclusions: A consensus of 112 endoscopic spine surgeons from 27 countries facilitated the development of a 2-dimensional classification system outlining the complexity of endoscopic spinal procedures, taking into account both technical aspects and morphological parameters. This classification system categorizes different endoscopic spine procedures and the pathologies they are employed to treat based on complexity, thus guiding the endoscopic spine community in medical training, patient education, and regulatory and reimbursement discussion. |
| format | Article |
| id | doaj-art-55fe2e4e3514455ea6052ea3d16d8f4c |
| institution | Kabale University |
| issn | 2666-5484 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | North American Spine Society Journal |
| spelling | doaj-art-55fe2e4e3514455ea6052ea3d16d8f4c2025-08-20T03:32:24ZengElsevierNorth American Spine Society Journal2666-54842025-06-012210060310.1016/j.xnsj.2025.100603Classification of endoscopic spine proceduresMazda Farshad, MD0Christoph J. Laux, MD1Florian Wanivenhaus, MD2José M. Spirig, MD3Jonas Widmer, PhD4Michael Kelly, MD5Javier Quillo-Olvera, MD6Jin-Sung Kim, MD7Facundo van Isseldyk, MD8Sohrab Gollogly, MD9James Yue, MD10Xuexiao Ma, MD11Vincent Hagel, MD12Frédéric Cornaz, MD13University Spine Center Zurich, Balgrist University Hospital, University of Zurich, Zurich, Switzerland; Corresponding author. Mazda Farshad, MD, University of Zurich, Forchstrasse 340, 8008 Zurich, Switzerland.University Spine Center Zurich, Balgrist University Hospital, University of Zurich, Zurich, SwitzerlandUniversity Spine Center Zurich, Balgrist University Hospital, University of Zurich, Zurich, SwitzerlandUniversity Spine Center Zurich, Balgrist University Hospital, University of Zurich, Zurich, SwitzerlandSpine Biomechanics, Balgrist University Hospital, University of Zurich, Zurich, SwitzerlandHospital for Special Surgery, New York, New York, United StatesHospital Spine Center- Neurological Surgery Department, Hospital Angeles Centro Sur, Queretaro City, MexicoSpine Center, Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South KoreaNational University of Rosario (UNR), Hospital Privado de Rosario (HPR) Rosario, ArgentinaDepartment of Surgery, Monterey Spine and Joint Center, Monterey, California, United StatesOrthopaedic Surgery, Frank H Netter School of Medicine, CT Orthopaedics, Hamden, Connecticut, United StatesAffiliated Hospital of Qingdao University, Qingdao, ChinaSpine Center, Asklepios Hospital Lindau, Lindau, GermanyUniversity Spine Center Zurich, Balgrist University Hospital, University of Zurich, Zurich, SwitzerlandABSTRACT: Background: A consensus on grading the complexity of endoscopic spinal procedures is lacking, but urgently needed to guide training, clinical practice, and regulatory concepts. Methods: A 2-dimensional classification system was developed, considering both the technical and morphological parameters contributing to the complexity of endoscopic spine procedures. An international survey with 68 questions - including those on demographic data and surgical volumes, suitability of the proposed 2-dimensional classification system, and categories of techniques and morphologies - was completed by spine surgeons with endoscopic experience. A consensus was defined as a difference >/= 10% between the most frequently given grade and the second most given grade. In cases of no clear consensus (ie, agreement of less than 10%), an additional analysis considering only the responses from surgeons with experience of more than 500 endoscopic spine surgeries was performed. Results: 115 survey entries were received, of which 112 were analyzed. The participating spine surgeons (64% orthopedic surgeons, 35% neurosurgeons, 1% other) originated from 27 countries and have performed an average of 509 endoscopic spine surgeries (55,984 total endoscopic procedures). 85.7% of the survey respondents agreed that the proposed 2-dimensional classification system was indeed appropriate for its particular purpose. Thus, a consensus classification system was born, allowing for grading simple procedures (eg, Ia for lumbar interlaminar discectomy of a soft disc herniation) to complex procedures (eg, IIIc for revision posterior endoscopic cervical central decompression). Conclusions: A consensus of 112 endoscopic spine surgeons from 27 countries facilitated the development of a 2-dimensional classification system outlining the complexity of endoscopic spinal procedures, taking into account both technical aspects and morphological parameters. This classification system categorizes different endoscopic spine procedures and the pathologies they are employed to treat based on complexity, thus guiding the endoscopic spine community in medical training, patient education, and regulatory and reimbursement discussion.http://www.sciencedirect.com/science/article/pii/S266654842500023XEndoscopyComplexityEndoSpineClassificationConsensusNomenclature |
| spellingShingle | Mazda Farshad, MD Christoph J. Laux, MD Florian Wanivenhaus, MD José M. Spirig, MD Jonas Widmer, PhD Michael Kelly, MD Javier Quillo-Olvera, MD Jin-Sung Kim, MD Facundo van Isseldyk, MD Sohrab Gollogly, MD James Yue, MD Xuexiao Ma, MD Vincent Hagel, MD Frédéric Cornaz, MD Classification of endoscopic spine procedures North American Spine Society Journal Endoscopy Complexity EndoSpine Classification Consensus Nomenclature |
| title | Classification of endoscopic spine procedures |
| title_full | Classification of endoscopic spine procedures |
| title_fullStr | Classification of endoscopic spine procedures |
| title_full_unstemmed | Classification of endoscopic spine procedures |
| title_short | Classification of endoscopic spine procedures |
| title_sort | classification of endoscopic spine procedures |
| topic | Endoscopy Complexity EndoSpine Classification Consensus Nomenclature |
| url | http://www.sciencedirect.com/science/article/pii/S266654842500023X |
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