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Full-Endoscopic Versus Microscopic Spinal Decompression For Lumbar Spinal Stenosis: A Systematic Review & Meta-Analysis London Spine Lumbar Stenosis

The article is a systematic review and meta-analysis comparing the safety and efficacy of endoscopic decompression versus microscopic decompression for the treatment of lumbar spinal stenosis. The study found that endoscopic decompression had several advantages over microscopic decompression, including reduced intraoperative blood loss, shorter hospital stays, lower rates of incidental durotomy and surgical site infections, and a trend towards better pain relief and functional outcomes up to 2 years follow up. The authors conclude that both techniques are safe and effective, but recommend larger prospective studies to compare potential alignment changes and destabilization

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best situated spine clinic on Harley Street UK

Published article

CONCLUSIONS: Endoscopic and microscopic decompression are safe and effective techniques for treatment of symptomatic lumbar spinal stenosis. Prospective studies of larger power considering medium to long-term outcomes and rates of iatrogenic instability are warranted to compare potential alignment changes and destabilization from either techniques.

Spine Lumbar Spinal Stenosis Expert. Best Spinal Surgeon UK
Abstract Background context: Symptomatic lumbar spinal stenosis is routinely treated with spinal decompression surgery, with an increasing trend towards minimally invasive techniques. Endoscopic decompression has emerged as a technique which minimizes approach-related morbidity while achieving similar clinical outcomes to conventional open or microscopic approaches. Purpose: To assess the safety and efficacy of endoscopic versus microscopic,

Abstract

Background context: Symptomatic lumbar spinal stenosis is routinely treated with spinal decompression surgery, with an increasing trend towards minimally invasive techniques. Endoscopic decompression has emerged as a technique which minimizes approach-related morbidity while achieving similar clinical outcomes to conventional open or microscopic approaches.

Purpose: To assess the safety and efficacy of endoscopic versus microscopic decompression for treatment of lumbar spinal stenosis.

Study design: Systematic review and meta-analysis.

Methods: A systematic review on randomized and non-randomized studies comparing endoscopic versus microscopic decompression was conducted, in accordance with PRISMA guidelines. Treatment effects were computed using pairwise random-effects meta-analysis. Risk of bias was assessed using the Cochrane Risk-of-bias and ROBINS-I tools for randomized and non-randomized trials respectively. Quality of the overall body of evidence was appraised using the GRADE system.

Results: A total of 19 primary references comprising 1997 patients and 2132 spinal levels were included. Endoscopic decompression was associated with significantly reduced intraoperative blood-loss (WMD = -33.29 mLs, 95% CI: -51.80 to -14.78, p = 0.0032), shorter duration of hospital stay (WMD = -1.79 days, 95% CI: -2.63 to 0.95, p = 0.001), rates of incidental durotomy (RR = 0.63, 95% CI: 0.43 to 0.91, p = 0.0184) and surgical site infections (RR = 0.23, 95% CI: 0.10 to – 0.51, p = 0.001), and a non-significant trend towards less back pain, leg pain, and better functional outcomes compared to its microscopic counterpart up to 2-year follow up.

Conclusions: Endoscopic and microscopic decompression are safe and effective techniques for treatment of symptomatic lumbar spinal stenosis. Prospective studies of larger power considering medium to long-term outcomes and rates of iatrogenic instability are warranted to compare potential alignment changes and destabilization from either techniques.

Keywords: endoscopic; lumbar spinal stenosis; meta-analysis; microscopic; minimally invasive; spinal decompression surgery; systematic review.

The London Spine Unit : best situated spine clinic on Harley Street UK

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Full-endoscopic versus microscopic spinal decompression for lumbar spinal stenosis: a systematic review & meta-analysis

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Abstract Background context: Symptomatic lumbar spinal stenosis is routinely treated with spinal decompression surgery, with an increasing trend towards minimally invasive techniques. Endoscopic decompression has emerged as a technique which minimizes approach-related morbidity while achieving similar clinical outcomes to conventional open or microscopic approaches. Purpose: To assess the safety and efficacy of endoscopic versus microscopic

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