Complications and Management in Endoscopic Spine Surgery

Endoscopic spine surgery (ESS) has emerged as a cornerstone of minimally invasive spinal care. By allowing targeted neural decompression through small portals with continuous irrigation, ESS minimizes muscle trauma and hastens recovery compared with open surgery. The technique has expanded from the lumbar spine to include thoracic and cervical pathologies, offering patients reduced postoperative pain, shorter hospital stays, and quicker return to daily activities. Despite these advantages, ESS is not without limitations; a steep learning curve, restricted working channels, and complex regional anatomy all predispose to unique complications. Awareness of the frequency and nature of these events is essential for informed consent, accurate patient counseling, and, ultimately, improved outcomes for our patients. This chapter synthesizes the current evidence on complications associated with endoscopic spine surgery and provides practical management strategies based on both the published literature and clinical experience.