The spine is the central axis of our body, extending from the neck to the back, waist, hips, and tail, and is composed of a total of 33 bones. It supports the main skeleton and protects internal organs. If there is a problem with the spine, the body's center collapses, affecting walking and damaging organs, leading to various diseases.
In South Korea, the number of patients with spinal diseases is increasing every year due to ultra-aging. Seventy-five percent of all patients are over the age of 50, and recently, there has been a trend of younger patients due to excessive use of smartphones, poor lifestyle habits, long periods of sitting, and lack of exercise. According to the Health Insurance Review and Assessment Service, the number of domestic spinal disease patients was about 9.6 million in 2023, a 14.3% increase from 2016 (about 8.4 million) in just seven years. One in four has visited a hospital due to spinal disease.
The representative spinal diseases are 'intervertebral disc protrusion,' commonly known as a herniated disc, and 'spinal stenosis,' where aged spinal bones thicken and compress the spinal nerves. When treatment with medication or anti-inflammatory injections is ineffective, spinal surgery is performed. Traditional spinal surgery involved general anesthesia, incisions in the skin, and significant surgery to resect the bone; however, recently, it has become common to use an endoscope in the lumbar area under local anesthesia to treat damaged tissue, allowing for a wider field of view.
Recently, endoscopic spinal surgery is undergoing a shift. The existing 'unidirectional endoscopic surgery,' where an endoscope and surgical instruments are inserted through a single hole, is evolving into 'bidirectional endoscopic surgery,' where two 5mm holes are created; one side contains the endoscope and the other has the surgical instruments, allowing for a bidirectional approach. This has emerged as the third generation of spinal surgery.
On the 4th, at Yonsei OK Hospital located in Uijeongbu, Gyeonggi Province, the director of the spine center and chief director, Ha Ji-soo, noted that he is an expert in this bidirectional endoscopic surgery. He stated, "Because the instruments are inserted into different holes, the treatment area is wider than in unidirectional surgery," adding, "This next-generation surgical treatment method removes the causes of spinal stenosis or disc issues, allowing the surgeon greater freedom in treating the patient's damaged tissue."
The smaller incision compared to traditional spinal surgery is also an advantage. Traditional surgeries tend to involve larger incisions, leading to tissue damage and significant blood loss, with relatively higher risks of infection and pain. Like unidirectional surgery, bidirectional surgery is performed underwater; therefore, the surgical site is continuously washed, reducing infection risks.
The theory behind bidirectional endoscopic spinal surgery was introduced in the early 2000s by South Korean doctors Eom Jin-hwa and Son Sang-kyu, and it has been advanced into a technique suitable for practical clinical application. It has now established itself as an internationally recognized endoscopic surgical method.
After first encountering bidirectional endoscopic spinal surgery 10 years ago, Director Ha taught himself the technique. His first patient was his uncle, who was suffering from spinal stenosis. After successfully performing his first surgery, he has now conducted more than 4,000 cases of bidirectional endoscopic surgery. After graduating from Jeonbuk National University College of Medicine in 2008, he earned a master's degree from Hallym University College of Medicine. He began his career as a professor of neurosurgery at Hallym University Kangdong Sacred Heart Hospital and later moved to Bundang Seoul National University Hospital, before becoming the head of the spine center at Uijeongbu Yonsei OK Hospital a year ago.
Director Ha introduced bidirectional endoscopic surgery as one of the techniques with the least side effects among existing spinal surgical methods. He mentioned, "Because the holes are much smaller, the size of the wound is smaller, leading to less pain, and the hospitalization period is around 2 to 3 days," adding, "A 96-year-old patient who had difficulty walking due to issues in six or seven segments in 2020 was able to walk just one day after the bidirectional surgery due to its effectiveness."
He also explained, "Spinal fusion surgery using screws is particularly burdensome for elderly patients; while traditional surgery would take four hours, the bidirectional surgery can be completed in less than two hours."
Director Ha is also known as an ambassador for bidirectional endoscopic surgery among doctors around the world. More than 200 doctors from the United States, Russia, India, Thailand, and other countries have visited the hospital to learn bidirectional endoscopic techniques. He participated in writing the textbook for bidirectional spinal surgery in the U.S.
Navin, an Indian doctor staying at the hospital for a month to learn the technique, noted, "Currently, 20 Indian doctors are being trained in this technique by Director Ha, treating many patients with spinal diseases at various hospitals in India." Director Ha is providing the training program for these medical personnel for free.
Previously, Director Ha, along with first and second generation spinal specialists, established the International Society for Bidirectional Endoscopic Spinal Surgery (The World UBE society) in 2017, after first encountering the bidirectional techniques 10 years ago. Currently, more than 400 medical professionals worldwide are registered members, with over 200 attending the conference annually.
Director Ha stated, "I believe that bidirectional endoscopic surgery will become the 'world standard' for spinal surgery in the future," and added, "We will further enhance the bidirectional technique by utilizing AI (artificial intelligence) robots."