Fluid dynamics and pressure control in endoscopic spine surgery

Abstract

A crucial aspect of endoscopic spine surgery is maintaining visual control. This is achieved through continuous irrigation, which keeps the surgical field clear. A steady flow of fluid flushes away blood and detached tissue, ensuring an unobstructed view for the surgeon. However, this can potentially influence pressure at various anatomical locations, including intradural, extradural, and intracranial compartments. Despite these concerns, there is limited understanding of the changes in physiological intraspinal and intracranial pressure during endoscopic spine surgery and the critical importance of fluid management and no formal guidelines for irrigation pump pressure or flow settings exist. Growing awareness of irrigation-related risks has prompted research into the fluid dynamics of endoscopic spine surgery and how to control intraspinal, intravascular, and intracranial pressures during these procedures.