As the number of patients receiving treatment for spinal disorders continues to rise, surgical techniques are also rapidly shifting from approaches that access lesions through large incisions in the skin and muscles to procedures that insert an endoscope and surgical instruments through small openings to remove lesions compressing nerves.
According to public-interest disease statistics from the Health Insurance Review and Assessment Service, the number of patients treated for spinal disorders increased 9.1%, from 8,912,158 in 2020 to 9,723,544 in 2024. The spread of lifestyles that place strain on the spine, including smartphone and computer use, along with population aging, is cited as a reason.
Conservative treatments such as medication, injections and physical therapy are prioritized for spinal disorders, but surgery is considered when symptoms do not improve or when nerve compression causes muscle weakness and other problems. Recently, minimally invasive surgery, which can reduce damage to normal tissue, has also been used in this process, making endoscopic spine surgery one of the main treatment options.
In fact, an analysis by Mokdong Himchan Hospital of spinal surgeries performed from 2015 to 2025 found that the total number of spinal surgeries decreased from 889 to 687, while endoscopic surgeries increased from 22 to 405, or approximately 18.4 times. The proportion of endoscopic surgeries among all spinal surgeries also rose from 2.5% to 59%. This means that approximately 6 out of 10 spinal surgeries were performed endoscopically over the 10-year period.
Endoscopic spine surgery involves making a small incision in the skin and performing the operation while directly viewing the lesion through an endoscope. Because the incision is small, it can reduce damage to normal muscles and ligaments and may help lessen postoperative pain and the burden of recovery. Among the 337 endoscopic surgeries analyzed by the hospital, the average operating time was 82.7 minutes and the average length of hospital stay was 4.1 days.
Endoscopic surgery is particularly widely used for herniated lumbar discs and spinal stenosis. When nerves are compressed by a protruding disc or a narrowed spinal canal, an endoscope can be used to selectively remove the lesion compressing the nerve or widen the narrowed space. In the neck, endoscopic surgery is also used in cases such as cervical disc herniation or narrowing of the openings through which nerves pass.
Lee Dong Chan, medical director of the Department of Neurosurgery at Mokdong Himchan Hospital, said, “The increasing use of endoscopic surgery shows that treatment for spinal disorders is shifting toward minimally invasive approaches,” adding, “It is important to relieve nerve compression while preserving as much as possible the structures involved in spinal stability, including the facet joints, muscles and ligaments.”
However, not all spinal disorders can be treated endoscopically. When the spinal structure itself must be corrected or lesions over a wide area must be removed, endoscopy alone may be insufficient. If the spine is severely unstable or deformed, spinal fusion to stabilize the spine may be necessary. For spinal tumors or trauma such as fractures and dislocations, open surgery or fusion may also be required depending on the size and location of the lesion and spinal stability.
Therefore, it is not appropriate to choose endoscopic surgery as the first option simply because it is available. Experts explain that it is important to select the appropriate surgical method, such as endoscopic surgery or fusion, by comprehensively considering the lesion’s location and size, spinal stability and the presence of deformity, as well as the patient’s symptoms and overall condition.
According to public-interest disease statistics from the Health Insurance Review and Assessment Service, the number of patients treated for spinal disorders increased 9.1%, from 8,912,158 in 2020 to 9,723,544 in 2024. The spread of lifestyles that place strain on the spine, including smartphone and computer use, along with population aging, is cited as a reason.
Conservative treatments such as medication, injections and physical therapy are prioritized for spinal disorders, but surgery is considered when symptoms do not improve or when nerve compression causes muscle weakness and other problems. Recently, minimally invasive surgery, which can reduce damage to normal tissue, has also been used in this process, making endoscopic spine surgery one of the main treatment options.
In fact, an analysis by Mokdong Himchan Hospital of spinal surgeries performed from 2015 to 2025 found that the total number of spinal surgeries decreased from 889 to 687, while endoscopic surgeries increased from 22 to 405, or approximately 18.4 times. The proportion of endoscopic surgeries among all spinal surgeries also rose from 2.5% to 59%. This means that approximately 6 out of 10 spinal surgeries were performed endoscopically over the 10-year period.
Endoscopic spine surgery involves making a small incision in the skin and performing the operation while directly viewing the lesion through an endoscope. Because the incision is small, it can reduce damage to normal muscles and ligaments and may help lessen postoperative pain and the burden of recovery. Among the 337 endoscopic surgeries analyzed by the hospital, the average operating time was 82.7 minutes and the average length of hospital stay was 4.1 days.
Endoscopic surgery is particularly widely used for herniated lumbar discs and spinal stenosis. When nerves are compressed by a protruding disc or a narrowed spinal canal, an endoscope can be used to selectively remove the lesion compressing the nerve or widen the narrowed space. In the neck, endoscopic surgery is also used in cases such as cervical disc herniation or narrowing of the openings through which nerves pass.
Lee Dong Chan, medical director of the Department of Neurosurgery at Mokdong Himchan Hospital, said, “The increasing use of endoscopic surgery shows that treatment for spinal disorders is shifting toward minimally invasive approaches,” adding, “It is important to relieve nerve compression while preserving as much as possible the structures involved in spinal stability, including the facet joints, muscles and ligaments.”
However, not all spinal disorders can be treated endoscopically. When the spinal structure itself must be corrected or lesions over a wide area must be removed, endoscopy alone may be insufficient. If the spine is severely unstable or deformed, spinal fusion to stabilize the spine may be necessary. For spinal tumors or trauma such as fractures and dislocations, open surgery or fusion may also be required depending on the size and location of the lesion and spinal stability.
Therefore, it is not appropriate to choose endoscopic surgery as the first option simply because it is available. Experts explain that it is important to select the appropriate surgical method, such as endoscopic surgery or fusion, by comprehensively considering the lesion’s location and size, spinal stability and the presence of deformity, as well as the patient’s symptoms and overall condition.