Endoskopische Zugänge zur Brustwirbelsäule

Purpose: In spinal surgery, endoscopic surgical techniques have been gaining increasing importance in recent years. Although the technique itself has existed for decades, it has only begun to spread more widely in recent years due to technological advancements and increasingly structured training concepts. Nowadays, endoscopic procedures can be performed on all regions of the spine, including the thoracic spine. Materials/Methods: The two standardised endoscopic techniques for the thoracic spine are the interlaminar and the transforaminal approaches. Additionally, there are individual case reports describing an endoscopic transthoracic or retropleural approach. These approaches are primarily used to treat degenerative pathologies such as spinal canal stenosis and herniated discs, but also ossifications of the ligamentum flavum or the posterior longitudinal ligament. In individual cases, the endoscopic approach can also be utilised for the treatment of rarer conditions such as infections, tumours, and spontaneously occurring dural injuries. Results: As in other areas of the spine, endoscopic techniques for the thoracic spine are believed to offer potential advantages over traditional methods, such as reduced postoperative pain and a shorter hospital stay or overall quicker recovery time. Conclusion: Endoscopic approaches to the thoracic spine presumably offer advantages over conventional surgical techniques. However, the currently available literature is insufficient to make well-founded statements about clinical outcomes and about future developments. Since these approaches consistently pose a challenge, they should only be performed by surgeons experienced in endoscopic techniques.