en جراحی اعصاب Neurosurgery مروری Review <div style="text-align: justify;"><span style="font-size:12pt"><span style="background:white"><span new="" roman="" style="font-family:" times=""><span lang="EN-GB" style="font-size:9.0pt"><span calibri="" style="font-family:"><span style="color:black">The objectives of spinal surgery include the effective decompression of neural structures, ensuring spinal stability, and the proper fixation of an unstable vertebral column. Such surgical aims necessitate unavoidable harm to healthy tissues, such as the spine and adjacent soft tissues, once spinal surgery commences. Significant injury to the normal vertebral structure and adjacent paraspinal tissues during the procedure can result in negative outcomes characterized by ongoing axial discomfort and the need for further operations due to new instances of spinal instability. A variety of strategies, including the use of microscopes, tubular retractor systems, percutaneous tools, and the exploration of innovative surgical techniques, have been employed to minimize damage to healthy tissues and enhance surgical results. Introduced approximately thirty years ago, endoscopic spine surgery (ESS) represents a less invasive approach and has gained widespread acceptance with the advancement of endoscopic surgical tools and the introduction of novel endoscopic techniques over the last two decades. In theory, ESS could be considered the optimal method for spinal operations due to its reduced impact on tissues and superior visualization of the operative area. Nonetheless, surgeons are often reluctant to adopt ESS because of its challenging learning curve and the absence of robust evidence supporting its surgical outcomes. This article examines the logic and benefits of ESS by analyzing relevant literature.</span></span></span><span lang="EN-GB" style="font-size:9.0pt"><span style="font-family:"Calibri",sans-serif"></span></span></span></span></span></div> Endoscopy,Spine,Surgery, 45 53 http://jsurgery.bums.ac.ir/browse.php?a_code=A-10-442-1&slc_lang=en&sid=1 Ali Sadeghzadeh Shiraz sadeghzadeha@mums.ac.ir 100319475328460011263 100319475328460011263 No Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Farhang Mirakhorli Mirakhorlif@mums.ac.ir 100319475328460011264 0009-0005-2754-1637 No Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Mohammadreza Rostami Mohammadrezarostami.st@gmail.com 100319475328460011265 0009-0004-4854-7387 No Faculty of Medicine, Xi'an Jiaotong University, Xi'an, China Kiana Rahmati rahmatik@mums.ac.ir 100319475328460011266 100319475328460011266 No Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Alireza Davoudi Alireza.davoodi7777@gmail.com 100319475328460011267 100319475328460011267 No Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mohammad Ali Abouei Mehrizi drabouei@yahoo.com 100319475328460011268 0009-0005-7486-1721 No Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Seyed Ali Shariat Razavi ali.razavi74@gmail.com 100319475328460011269 100319475328460011269 No Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Mehran Sedaghat drpak.n@gmail.com 100319475328460011270 0009-0006-9914-0725 Yes Department OF Neurosurgery, Mir Hosseini Hospital, Shiraz, Iran