PT  - JOURNAL ARTICLE
AU  - Liu, Daniel
AU  - Mobbs, Ralph Jasper
TI  - Risk Analysis of Neurological Deterioration Associated With Fluid Insufflation in Uniportal Spine Endoscopy: A Case Series and Literature Review
AID  - 10.14444/8730
DP  - 2025 Mar 11
TA  - International Journal of Spine Surgery
PG  - 8730
4099  - https://www.ijssurgery.com/content/early/2025/03/11/8730.short
4100  - https://www.ijssurgery.com/content/early/2025/03/11/8730.full
AB  - Background Uniportal spine endoscopy is a minimally invasive technique gaining widespread popularity, but fluid insufflation during the procedure poses risks of neurological deterioration. The present study examines these risks through a case series and literature review.Methods A review of the literature was conducted to identify reported complications related to fluid insufflation. Additionally, we present a case series of 3 patients who experienced neurological deterioration associated with irrigation pressures.Results Key findings from the literature include complications such as raised intracranial pressure, seizures, durotomy-induced injuries, and unintended fluid migration. This case series describes novel complications, including transient ipsilateral weakness and lumbosacral plexopathy, linked to high irrigation pressures.Conclusion Neurological deterioration, though rare, is a significant risk in uniportal spine endoscopy. Future research should focus on defining optimal irrigation parameters and pressure management strategies.Clinical RelevanceBy understanding the mechanisms in which fluid insufflation may cause neurological deterioration and by consequently adopting preventive strategies, surgeons can reduce complications and improve patient outcomes.Level of Evidence 4.