M inimally invasive spine surgery (MISS) has trans- formed the fi eld of spinal surgery, offering reduced tissue disruption, faster recovery, and shorter hospital stays compared with traditional open approaches. 1 En- doscopic spine surgery represents an advancement in minimally invasive techniques, using an endoscope through tiny ports rather than traditional tubular re- tractors to access the spine. 2 – 4 To address the challenges encountered in the 1990s with maintaining surgical visu- alization and instrument manipulation through a single port, biportal endoscopic spine surgery (BESS) was de- veloped, incorporating two separate working portals to

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