Camp Foster, Okinawa, Japan – Lt. Cmdr. Ki Chang, a Navy Medical Corps Officer and Staff Neurosurgeon at Naval Medical Center San Diego performed the first uniportal endoscopic spine surgery at U.S. Naval Hospital Okinawa (USNHO) this week.
Lt. Cmdr. Ki Chang, a staff neurosurgeon at Naval Medical Center San Diego, is on a four-month temporary assignment to the USNHO. The procedure he performed represents the latest in minimally invasive techniques for treating common spinal conditions.
The military healthcare system provides physicians and other providers unique opportunities to practice in various environments and on a diverse patient population. This diversity in education, training, and experience allows for the sharing of cutting-edge procedures throughout the system, ensuring warfighters have access to the most current medical care.
Because U.S. Naval Hospital Okinawa does not offer the same complexity in trauma cases as a larger metropolitan area, surgeons rotate through the facility and to keep their surgical skills sharp, they can perform these new procedures. This allows USNHO the ability to offer this new option for it’s patients. The integration between the services, a key benefit since the Defense Health Agency took command and control of the armed forces healthcare system, allows for shared resources, best practices, and innovation.
"Uniportal endoscopic spine surgery represents the most minimally invasive technique currently available for treating common spinal conditions such as lumbar disc herniations and foraminal stenosis," Chang explained. "Through a single, small incision, surgeons can access the spine using a high-definition endoscope, minimizing disruption to surrounding muscle, bone, and soft tissue." He said this approach allows for precise decompression of neural elements while preserving normal anatomy.
"One of the greatest advantages of the uniportal technique is its ability to directly target pathology in the foraminal and extraforaminal zones—areas that have traditionally been difficult to access without more invasive exposures," Chang said. "Using a transforaminal or contralateral endoscopic approach, surgeons can visualize and decompress the exiting nerve root along its entire course."
This minimally invasive surgery offers meaningful benefits for patients, including reduced tissue damage, less postoperative pain, shorter hospital stays, and faster functional recovery. For active-duty service members, these advantages are mission-critical, enabling a quicker return to full operational capability.
While widely adopted in parts of Asia and Europe, uniportal endoscopic spine surgery is a highly specialized skill in the United States. Its introduction at Naval Hospital Okinawa marks a significant expansion of advanced surgical capability in the Indo-Pacific region, ensuring service members have access to state-of-the-art spine care without medical evacuation.
"Endoscopic techniques keep our Sailors and Marines in the battle," Chang said. "The procedure is motion-preserving and helps deal with the pain expeditiously. It is minimally invasive and offers the best chance to return to and stay in the fight."
The successful implementation of this surgery at the hospital reflects a broader commitment to innovation and readiness in military medicine, combining cutting-edge technology with advanced surgical expertise to improve patient outcomes.
U.S. Navy Medicine Readiness and Training Command Okinawa supports the Defense Health Agency's U.S. Naval Hospital Okinawa, which is the largest overseas medical treatment facility staffed by active-duty Navy personnel and stands at the ready to respond to contingency operations to support the U.S. Indo-Pacific Command’s area of operations. It is a critical regional asset for direct care delivery, regional referrals, and medical contingency operations. The staff at USNH Okinawa understand their vital role as pre-positioned, forward-deployed naval forces within the first island chain, aligned and in support of joint military commands and operations.
Trey Savitz, Public Affairs Officer
U.S. Naval Hospital Okinawa, Japan
Comm: 011-81-971-7024
DSN: (315) 646-7024
isaac.s.savitz.civ@health.mil