Endoscopic Spine Surgery: A French National Survey on Practices, Motivations, and Challenges

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Figure 1
Experience of surgeons in endoscopy.
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Figure 2
Volume of endoscopic spine surgery cases performed per month by spine surgeons in France.
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Figure 3
Barriers faced by surgeons for the usage of endoscopy in spine surgery.

Table 1

Questionnaire distributed to spine surgeons.

Survey Questions for Endoscopy Users
1. Do you perform spine surgery using endoscopic techniques?
2. Are you an orthopedic surgeon or a neurosurgeon?
3. Do you work in the public or private sector?
4. How did you learn endoscopic spine surgery?
5. Which endoscopic technique to you use?
6. For how long have you been practicing endoscopic spine surgery?
7. Which surgical procedures do you perform using endoscopy?
8. Why did you choose to practice this surgery?
9. Do you perform transforaminal approaches several times per month?
10. What is your monthly volume of endoscopic spine surgeries?
11. Has your average operating time increased for discectomies since performing endoscopic surgery?
12. What percentage of your spine surgeries are performed endoscopically?
13. Have you observed specific advantages of endoscopy compared to traditional techniques?
14. If yes, what advantages have you observed?
15. Under what type of anesthesia do you perform endoscopic spine surgery?
16. In your opinion, what are the main barriers to a wider adoption of endoscopic spine surgery in France?

Survey Questions for Endoscopy Nonusers
1. Are you an orthopedic surgeon or neurosurgeon?
2. Do you work in the public or private sector?
3. Do you perform spine surgery using endoscopic techniques?
4. Did you attend the endoscopic surgery day organized by the SFCR on October 13, 2023?
5. If not, why?
6. If you did not use endoscopy, which techniques do you use for lumbar disc herniation?

Table 2

Different approaches used for endoscopy by spine surgeons in France (n = 39).

Approaches Used	n (%)
Interlaminar discectomy	36 (97.3%)
Transforaminal discectomy	25 (67.6%)
Bilateral lumbar decompression	29 (78.4%)
Posterior cervical foraminotomy	10 (27%)
Posterior cervical discectomy	8 (21.6%)
Thoracic discectomy	4 (10.8%)
Lumbar fusion	5 (13.5%)