{"id":"https://openalex.org/W7224820448","doi":"https://doi.org/10.21182/jmisst.2026.03818","title":"Barriers, Costs, and Surgeons\u2019 Perspectives on Endoscopic Spine Surgery: A Unilateral Biportal Endoscopy-Focused Survey Analysis","display_name":"Barriers, Costs, and Surgeons\u2019 Perspectives on Endoscopic Spine Surgery: A Unilateral Biportal Endoscopy-Focused Survey Analysis","publication_year":2026,"publication_date":"2026-10-30","ids":{"openalex":"https://openalex.org/W7224820448","doi":"https://doi.org/10.21182/jmisst.2026.03818"},"language":"en","primary_location":{"id":"doi:10.21182/jmisst.2026.03818","doi":"https://doi.org/10.21182/jmisst.2026.03818","is_oa":true,"landing_page_url":"https://doi.org/10.21182/jmisst.2026.03818","pdf_url":"https://www.jmisst.org/upload/pdf/jmisst-2026-03818.pdf","source":{"id":"https://openalex.org/S4210227605","display_name":"Journal of Minimally Invasive Spine Surgery and Technique","issn_l":"2508-2043","issn":["2508-2043"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Minimally Invasive Spine Surgery and Technique","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://www.jmisst.org/upload/pdf/jmisst-2026-03818.pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5145998107","display_name":"Sehajvir Singh","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1285301757","display_name":"Rush University Medical Center","ror":"https://ror.org/01j7c0b24","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1285301757"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Sehajvir Singh","raw_affiliation_strings":["Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA","institution_ids":["https://openalex.org/I1285301757"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5111097965","display_name":"Shreya Kurup","orcid":"https://orcid.org/0009-0007-2542-6509","observed_orcids":["https://orcid.org/0009-0007-2542-6509"]},"institutions":[{"id":"https://openalex.org/I1285301757","display_name":"Rush University Medical Center","ror":"https://ror.org/01j7c0b24","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1285301757"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Shreya Kurup","raw_affiliation_strings":["Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA","institution_ids":["https://openalex.org/I1285301757"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5120788887","display_name":"Noah A. Pogonitz","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1285301757","display_name":"Rush University Medical Center","ror":"https://ror.org/01j7c0b24","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1285301757"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Noah A. Pogonitz","raw_affiliation_strings":["Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA","institution_ids":["https://openalex.org/I1285301757"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5147504186","display_name":"Aimen A. Khan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1285301757","display_name":"Rush University Medical Center","ror":"https://ror.org/01j7c0b24","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1285301757"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Aimen A. Khan","raw_affiliation_strings":["Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA","institution_ids":["https://openalex.org/I1285301757"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5102540934","display_name":"Puranjay Gupta","orcid":"https://orcid.org/0000-0003-2629-0416","observed_orcids":["https://orcid.org/0000-0003-2629-0416"]},"institutions":[{"id":"https://openalex.org/I1285301757","display_name":"Rush University Medical Center","ror":"https://ror.org/01j7c0b24","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1285301757"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Puranjay Gupta","raw_affiliation_strings":["Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA","institution_ids":["https://openalex.org/I1285301757"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160155123","display_name":"Michael Knipp","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I189273616","display_name":"Rosalind Franklin University of Medicine and Science","ror":"https://ror.org/04fegvg32","country_code":"US","type":"education","lineage":["https://openalex.org/I189273616"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Michael Knipp","raw_affiliation_strings":["Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA","institution_ids":["https://openalex.org/I189273616"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5147601139","display_name":"Aryan Patel","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1285301757","display_name":"Rush University Medical Center","ror":"https://ror.org/01j7c0b24","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1285301757"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Aryan Patel","raw_affiliation_strings":["Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA","institution_ids":["https://openalex.org/I1285301757"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5063167570","display_name":"Maximillian Y. Lee","orcid":"https://orcid.org/0009-0004-2751-1529","observed_orcids":["https://orcid.org/0009-0004-2751-1529"]},"institutions":[{"id":"https://openalex.org/I1285301757","display_name":"Rush University Medical Center","ror":"https://ror.org/01j7c0b24","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1285301757"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Maximillian Y. Lee","raw_affiliation_strings":["Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA","institution_ids":["https://openalex.org/I1285301757"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5036055362","display_name":"Aditya S. Mazmudar","orcid":"https://orcid.org/0000-0002-4628-4067","observed_orcids":["https://orcid.org/0000-0002-4628-4067"]},"institutions":[{"id":"https://openalex.org/I2799903593","display_name":"Georgetown University Medical Center","ror":"https://ror.org/00hjz7x27","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2799903593"]},{"id":"https://openalex.org/I2802534011","display_name":"MedStar Georgetown University Hospital","ror":"https://ror.org/03ja1ak26","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2802534011","https://openalex.org/I86755215"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Aditya S. Mazmudar","raw_affiliation_strings":["MedStar Orthopedic Institute, MedStar Georgetown University Hospital, Washington, D.C., USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"MedStar Orthopedic Institute, MedStar Georgetown University Hospital, Washington, D.C., USA","institution_ids":["https://openalex.org/I2799903593","https://openalex.org/I2802534011"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160220385","display_name":"Daniel K. Park","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1285301757","display_name":"Rush University Medical Center","ror":"https://ror.org/01j7c0b24","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1285301757"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Daniel K. Park","raw_affiliation_strings":["Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA","institution_ids":["https://openalex.org/I1285301757"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5011101093","display_name":"Kern Singh","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1285301757","display_name":"Rush University Medical Center","ror":"https://ror.org/01j7c0b24","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1285301757"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Kern Singh","raw_affiliation_strings":["Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA","institution_ids":["https://openalex.org/I1285301757"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":4,"corresponding_author_ids":["https://openalex.org/A5011101093"],"corresponding_institution_ids":["https://openalex.org/I1285301757"],"apc_list":null,"apc_paid":null,"fwci":4.5185,"has_fulltext":true,"cited_by_count":1,"citation_normalized_percentile":{"value":0.9581203,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":92,"max":96},"biblio":{"volume":"11","issue":"2","first_page":"228","last_page":"239"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10238","display_name":"Spine and Intervertebral Disc Pathology","score":0.9765999913215637,"subfield":{"id":"https://openalex.org/subfields/2734","display_name":"Pathology and Forensic Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10238","display_name":"Spine and Intervertebral Disc Pathology","score":0.9765999913215637,"subfield":{"id":"https://openalex.org/subfields/2734","display_name":"Pathology and Forensic Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11030","display_name":"Scoliosis diagnosis and treatment","score":0.0032999999821186066,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10776","display_name":"Spinal Fractures and Fixation Techniques","score":0.003100000089034438,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/endoscopic-spine-surgery","display_name":"endoscopic spine surgery","score":0.996999979019165},{"id":"https://openalex.org/keywords/unilateral-biportal-endoscopy","display_name":"unilateral biportal endoscopy","score":0.9990000128746033},{"id":"https://openalex.org/keywords/surgeon-perspectives","display_name":"surgeon's perspective","score":0.640999972820282},{"id":"https://openalex.org/keywords/barriers-to-adoption","display_name":"barriers to adoption","score":0.9309999942779541},{"id":"https://openalex.org/keywords/payment-models","display_name":"payment models","score":0.6010000109672546},{"id":"https://openalex.org/keywords/surgical-training","display_name":"surgical training","score":0.8009999990463257},{"id":"https://openalex.org/keywords/start-up-costs","display_name":"start-up costs","score":0.6299999952316284},{"id":"https://openalex.org/keywords/hospital-support-services","display_name":"hospital support","score":0.5759999752044678},{"id":"https://openalex.org/keywords/minimally-invasive-spine-surgery","display_name":"minimally invasive spine surgery","score":0.8240000009536743},{"id":"https://openalex.org/keywords/lumbar-spine","display_name":"lumbar spine","score":0.625},{"id":"https://openalex.org/keywords/cervical-spine","display_name":"cervical spine","score":0.7360000014305115},{"id":"https://openalex.org/keywords/thoracic-spine","display_name":"thoracic spine","score":0.9300000071525574},{"id":"https://openalex.org/keywords/insurance-coverage","display_name":"insurance coverage","score":0.8100000023841858}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8156999945640564},{"id":"https://openalex.org/C2779703844","wikidata":"https://www.wikidata.org/wiki/Q760125","display_name":"Reimbursement","level":3,"score":0.7124000191688538},{"id":"https://openalex.org/C68312169","wikidata":"https://www.wikidata.org/wiki/Q216685","display_name":"Orthopedic surgery","level":2,"score":0.4875999987125397},{"id":"https://openalex.org/C2778451229","wikidata":"https://www.wikidata.org/wiki/Q212809","display_name":"Endoscopy","level":2,"score":0.48260000348091125},{"id":"https://openalex.org/C61434518","wikidata":"https://www.wikidata.org/wiki/Q932510","display_name":"General surgery","level":1,"score":0.4503999948501587},{"id":"https://openalex.org/C39896193","wikidata":"https://www.wikidata.org/wiki/Q380344","display_name":"Descriptive statistics","level":2,"score":0.41749998927116394},{"id":"https://openalex.org/C2992394448","wikidata":"https://www.wikidata.org/wiki/Q7246234","display_name":"Private practice","level":2,"score":0.414900004863739},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.39640000462532043},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.36570000648498535},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.34700000286102295},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.33410000801086426},{"id":"https://openalex.org/C173481278","wikidata":"https://www.wikidata.org/wiki/Q7257997","display_name":"Survey research","level":2,"score":0.3183000087738037},{"id":"https://openalex.org/C3017433307","wikidata":"https://www.wikidata.org/wiki/Q405478","display_name":"Lumbar spine","level":2,"score":0.31790000200271606},{"id":"https://openalex.org/C142052008","wikidata":"https://www.wikidata.org/wiki/Q954027","display_name":"Cross-sectional study","level":2,"score":0.2935999929904938},{"id":"https://openalex.org/C2988501903","wikidata":"https://www.wikidata.org/wiki/Q212809","display_name":"Endoscopic surgery","level":3,"score":0.2872999906539917},{"id":"https://openalex.org/C20387591","wikidata":"https://www.wikidata.org/wiki/Q930752","display_name":"Specialty","level":2,"score":0.2818000018596649},{"id":"https://openalex.org/C2778818304","wikidata":"https://www.wikidata.org/wiki/Q1819478","display_name":"Rehabilitation","level":2,"score":0.28119999170303345},{"id":"https://openalex.org/C187960798","wikidata":"https://www.wikidata.org/wiki/Q7631152","display_name":"Subgroup analysis","level":3,"score":0.27239999175071716},{"id":"https://openalex.org/C19648533","wikidata":"https://www.wikidata.org/wiki/Q691640","display_name":"Evidence-based medicine","level":3,"score":0.2653000056743622},{"id":"https://openalex.org/C44575665","wikidata":"https://www.wikidata.org/wiki/Q1293405","display_name":"Lumbar","level":2,"score":0.25220000743865967}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.21182/jmisst.2026.03818","doi":"https://doi.org/10.21182/jmisst.2026.03818","is_oa":true,"landing_page_url":"https://doi.org/10.21182/jmisst.2026.03818","pdf_url":"https://www.jmisst.org/upload/pdf/jmisst-2026-03818.pdf","source":{"id":"https://openalex.org/S4210227605","display_name":"Journal of Minimally Invasive Spine Surgery and Technique","issn_l":"2508-2043","issn":["2508-2043"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Minimally Invasive Spine Surgery and Technique","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.21182/jmisst.2026.03818","doi":"https://doi.org/10.21182/jmisst.2026.03818","is_oa":true,"landing_page_url":"https://doi.org/10.21182/jmisst.2026.03818","pdf_url":"https://www.jmisst.org/upload/pdf/jmisst-2026-03818.pdf","source":{"id":"https://openalex.org/S4210227605","display_name":"Journal of Minimally Invasive Spine Surgery and Technique","issn_l":"2508-2043","issn":["2508-2043"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Minimally Invasive Spine Surgery and Technique","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9391000270843506,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7224820448.pdf","grobid_xml":"https://content.openalex.org/works/W7224820448.grobid-xml"},"referenced_works_count":32,"referenced_works":["https://openalex.org/W2916925925","https://openalex.org/W2943688522","https://openalex.org/W2982467432","https://openalex.org/W2999967402","https://openalex.org/W3048373009","https://openalex.org/W3137006064","https://openalex.org/W3179755079","https://openalex.org/W3184871919","https://openalex.org/W4212770261","https://openalex.org/W4221061737","https://openalex.org/W4223651718","https://openalex.org/W4281256467","https://openalex.org/W4322491783","https://openalex.org/W4322718830","https://openalex.org/W4323980105","https://openalex.org/W4362505690","https://openalex.org/W4387610824","https://openalex.org/W4390748917","https://openalex.org/W4392358335","https://openalex.org/W4399178956","https://openalex.org/W4401715187","https://openalex.org/W4402401227","https://openalex.org/W4402656303","https://openalex.org/W4404768788","https://openalex.org/W4406893860","https://openalex.org/W4407426821","https://openalex.org/W4410914715","https://openalex.org/W4410956022","https://openalex.org/W4411634849","https://openalex.org/W4411670107","https://openalex.org/W4412424641","https://openalex.org/W4414535208"],"related_works":["https://openalex.org/W7203759022","https://openalex.org/W4407426821","https://openalex.org/W7167809163","https://openalex.org/W4404768788","https://openalex.org/W4390295938","https://openalex.org/W7221189540","https://openalex.org/W4221061737","https://openalex.org/W4312710320","https://openalex.org/W4416743843","https://openalex.org/W2987163696"],"abstract_inverted_index":{"Objective:":[0],"Unilateral":[1,78,84],"biportal":[2],"endoscopy":[3],"(UBE)":[4],"and":[5,31,59,67,82,100,114,146,168,196,214,251,270,284,287],"endoscopic":[6],"spine":[7,70],"surgery":[8],"(ESS)":[9],"are":[10],"minimally":[11],"invasive":[12],"techniques,":[13],"but":[14],"their":[15,223],"integration":[16],"into":[17],"routine":[18],"surgical":[19],"practice":[20,42],"remains":[21],"variable.":[22],"Factors":[23],"influencing":[24],"global":[25],"adoption,":[26],"particularly":[27],"cost,":[28],"training,":[29,281],"reimbursement,":[30,250],"institutional":[32],"support,":[33,195],"remain":[34],"incompletely":[35],"characterized.":[36],"This":[37,230],"survey":[38,64,231,263],"study":[39],"evaluated":[40],"ESS":[41,92,104,144,160,171,184,220,236,280],"perspectives":[43],"among":[44,237],"members":[45,238],"of":[46,77,125,138,143,153,177,201,239],"2":[47],"international":[48],"UBE":[49],"societies,":[50,241],"focusing":[51],"on":[52],"surgeon":[53,90,212],"expertise,":[54],"reimbursement":[55,94,197,289],"models,":[56],"training":[57,98,247],"exposure,":[58,99],"perceived":[60],"barriers.Methods:":[61],"An":[62],"electronic":[63],"was":[65,157,185,264],"developed":[66],"distributed":[68],"to":[69,110,246,266],"surgeons":[71,122,129],"affiliated":[72],"with":[73,159],"the":[74,226,262],"European":[75],"Society":[76],"Biportal":[79,85],"Endoscopy":[80],"Association":[81],"World":[83],"Endoscopy-America.":[86],"The":[87],"questionnaire":[88],"assessed":[89,118],"demographics,":[91],"experience,":[93,145],"patterns,":[95,113],"cost-related":[96],"barriers,":[97],"expectations":[101],"for":[102,183],"future":[103],"use.":[105],"Descriptive":[106],"statistics":[107],"were":[108,117,127,172,216],"used":[109],"summarize":[111],"response":[112],"subgroup":[115],"differences":[116],"by":[119,161],"region.Results:":[120],"Seventy-eight":[121],"responded,":[123],"most":[124],"whom":[126],"orthopedic":[128],"(60.3%)":[130],"practicing":[131],"primarily":[132],"in":[133,222],"private":[134],"hospitals":[135],"(57.7%).":[136],"Half":[137],"respondents":[139,163,178,202],"had":[140,148],"1\u20135":[141],"years":[142],"34.6%":[147],"less":[149,173],"than":[150],"1":[151],"year":[152],"experience.":[154],"Lumbar":[155],"pathology":[156],"treated":[158],"all":[162,275],"(100%),":[164],"whereas":[165],"cervical":[166],"(47.4%)":[167],"thoracic":[169],"(38.5%)":[170],"common.":[174],"Only":[175],"7.7%":[176],"reported":[179,203,209],"that":[180],"insurance":[181],"coverage":[182],"\u201cvery":[186,204,210,217],"easy.\u201d":[187],"Key":[188],"barriers":[189,244],"included":[190],"startup":[191],"costs,":[192,286],"limited":[193,265],"hospital":[194],"challenges.":[198],"Nevertheless,":[199],"42.3%":[200],"high\u201d":[205,211],"patient":[206],"interest,":[207,213],"41.0%":[208],"55.1%":[215],"optimistic\u201d":[218],"about":[219],"growth":[221],"country":[224],"over":[225],"next":[227],"5":[228],"years.Conclusion:":[229],"identified":[232],"substantial":[233],"optimism":[234],"regarding":[235],"UBE-focused":[240,268],"despite":[242],"persistent":[243],"related":[245],"limitations,":[248],"inadequate":[249],"high":[252],"capital":[253,283],"investment.":[254],"These":[255],"findings":[256],"may":[257,291],"not":[258,272],"be":[259],"generalizable":[260],"because":[261],"selected":[267],"societies":[269],"did":[271],"evenly":[273],"represent":[274],"geographic":[276],"regions.":[277],"Expanding":[278],"formal":[279],"reducing":[282],"disposable":[285],"refining":[288],"models":[290],"support":[292],"broader":[293],"adoption.":[294]},"counts_by_year":[{"year":2026,"cited_by_count":1}],"updated_date":"2026-11-01T11:40:01.658920","created_date":"2026-10-31T00:00:00"}