A Terminological Suggestion for Spinal Endoscopes

1. The Thriving Development of Spinal Endoscopy

Initially, the application of endoscopic spine surgery was focused on lumbar degenerative disc disease, and intervertebral discs. As surgical instruments and techniques continued to evolve, endoscopic spine surgery had expanded to other regions of the spine, such as the cervical and thoracic spine [4,5]. This expansion opened new possibilities for the treatment of various spinal pathologies, including spinal stenosis, spinal deformities, spinal infection and spinal tumors.

2. The Names of Various Spinal Endoscopes

With the widening range of procedures performed using endoscopic techniques, a plethora of nomenclatures emerged, describing the different surgical approaches. However, the absence of a standardized terminology hindered effective communication and prevented the comparison of outcomes between different studies and surgical centers.

To address this issue, a significant milestone was achieved in 2020 when a consensus was reached on the naming of ‘full endoscopic spinal surgery,’ providing a standardized classification of these procedures [6]. This consensus aimed to bring clarity and uniformity to the field, allowing for more accurate reporting, comparison, and analysis of outcomes. However, certain procedures, despite using endoscope during the surgery, such as Destandau, unilateral biportal endoscopic decompression and fusion, transforaminal endoscopic lumbar interbody fusion, endoscopic oblique lateral interbody fusion, microendoscopic discectomy, microendoscopic laminotomy were classified as endoscopy-assisted surgery rather than full endoscopic spine surgery [6]. Recent studies have demonstrated that the prognosis of endoscopy-assisted surgery is comparable to that of full endoscopic spine surgery, highlighting the need for a terminology that encompasses both approaches [7,8].

Considering these developments, there is a need for a comprehensive nomenclature that captures the breadth of endoscopic surgical techniques utilized in the treatment of spinal disorders. The co-corresponding author of the article Dr. Hyeun Sung Kim proposed the term 'spinoscope' to address this requirement, serving as an inclusive descriptor that includes all endoscopic procedures performed on the spine. By adopting the term 'spinoscope,' the medical community can foster a unified language. For instance, if a spine surgeon is interested in entering the field of endoscopic spine surgery, they might search for the term “full endoscopic spine surgery.” In doing so, they could potentially overlook techniques like biportal endoscopic surgery or the Destandau. However, by unifying these techniques under the term 'spinoscope' to represent all spine surgeries using endoscopic techniques, such confusion can be avoided (Figure 1).

Figure 1.

The term “spinoscope” encompasses all types of spinal surgery using an endoscope. The bubble size represents the volume of published articles in PubMed, with the numbers indicating the total article count.

The spine comprises intervertebral discs, vertebral bodies, facet joints, and even nerves (Figure 2). Therefore, instead of using more narrowly defined terms like 'vertebroscope,' we utilize the term 'spinoscope' to encompass all endoscopic surgical procedures used for the spine, just as the term 'laparoscope' is used to collectively refer to endoscopic surgeries performed in the abdominal cavity.

Figure 2.

The spine consists of intervertebral discs, vertebral bodies, facet joints, ligaments, vessels, dura, and nerves. All these structures are potential treatment targets for the spinoscope.