Innovations may help reduce saline consumption in endoscopic spine surgeries: study

Written By : Dr Supreeth D R Published On 2026-02-10T20:00:54+05:30 | Updated On 10 Feb 2026 8:01 PM IST

The environmental footprint of healthcare has become a growing concern, but the specific resource consumption associated with spine surgery remains largely unexplored. Despite the widespread use of continuous saline irrigation in endoscopic spine surgery, no study has previously compared the volume of saline consumption across different surgical techniques.

Xavier Castel et al conducted a study to compare saline consumption across three surgical techniques for lumbar disc herniation: classical microdiscectomy (MD), uniportal endoscopy (FE), and biportal endoscopy (UBE). The article has been published in “European Spine Journal.”

This was an international multicenter retrospective study conducted in France, Italy, and Switzerland. It included 722 patients who underwent lumbar disc herniation surgery. Patients were grouped based on the surgical technique used: MD (n = 127), FE (n = 253), and UBE (n = 342). The primary outcome was total saline consumption (Liters). Data collected included also demographic information and surgical duration. Statistical analyses included Kruskal-Wallis tests, pairwise comparisons with Bonferroni correction, ROC curve analysis, and a fixed-effects model to assess factors influencing saline consumption.

The key findings were:

• Saline consumption varied significantly across techniques, with a median (IQR) of 0.08 L (0.02–0.15) for MD, 4.00 L (3.00–6.00) for FE, and 9.00 L (6.00–13.00) for UBE (p < 0.0001) FE technique consume approximately 50 times more saline than MD, and UBE consume more than 112 times more saline than MD.

• No significant correlation was found between saline consumption and patient age or BMI.

The authors concluded – “Endoscopic techniques for lumbar disc herniation require substantially more saline than classical MD. This highlights the need for strategies promoting responsible resource stewardship in spine surgery. Future innovations, such as closed-loop fluid management systems, may help optimize both environmental sustainability and economic efficiency.”

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.