The structured debate compares endoscopic decompression and fusion across seven domains. Survey data from 63 endoscopic-spine surgeons favored decompression for stable single-level disease and fusion when objective instability is present.
Key findings
- Decompression is favored for selected stable low-grade DLS
- Fusion remains appropriate when instability or mechanical pain is present
- Long-term multicenter randomized evidence is still needed
Why this matters globally
The findings support phenotype-based surgical decision-making rather than one-size-fits-all technique selection.
Thai researcher contribution
A Chulalongkorn University-affiliated researcher contributed to the study.
Limitations to consider
The survey panel was enriched for endoscopic-spine expertise and may not represent the broader spine-surgery community.