Review Assesses Evidence and U.S. Adoption Barriers for Endoscopic Spine Surgery

A review in The Journal of Bone and Joint Surgery, American Volume examines evidence maturity and barriers to U.S. adoption of endoscopic spine surgery (ESS). It reports that higher-level evidence supports clinical outcomes comparable with microscopic and tubular techniques for lumbar disc herniation and spinal stenosis. The supplied summary does not provide study counts, patient numbers, endpoint definitions, or quantitative effect estimates.

Evidence for cervical and thoracic ESS is less developed, with a lack of contemporary multicenter randomized trials and substantial reliance on single-center retrospective data. Despite increasing interest and fellowship exposure, U.S. adoption remains constrained by a steep learning curve, limited training pathways, and reimbursement challenges.

Economic viability depends on the facility: higher disposable costs may be offset by lower hospital resource use, and migration to ambulatory surgery centers could create additional adoption opportunities. The review identifies standardized training, multi-institutional outcome registries, and alignment with value-based payment models—including the 2026 Medicare Transforming Episode Accountability Model (TEAM)—as requirements for broader integration. Its findings distinguish the more mature lumbar evidence from the remaining uncertainties in cervical and thoracic applications.