• Don Y Park, Alexander Upfill-Brown, Nora Curtin, Christopher D Hamad, Akash Shah, Brian Kwon, Yong H Kim, Dong Hwa Heo, Cheol Woong Park, and William L Sheppard.
• Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, 16th Street, Suite 3142, Los Angeles, Santa Monica, CA, 90404, USA. dypark@mednet.ucla.edu.
• Eur Spine J. 2023 Aug 1; 32 (8): 263726462637-2646.

PurposeCurrent literature suggests that biportal spinal endoscopy is safe and effective in treating lumbar spine pathology such as lumbar disc herniation, lumbar stenosis, and degenerative spondylolisthesis. No prior study has investigated the postoperative outcomes or complication profile of the technique as a whole. This study serves as the first comprehensive systematic review and meta-analysis of biportal spinal endoscopy in the lumbar spine.MethodsA PubMed literature search provided over 100 studies. 42 papers were reviewed and 3673 cases were identified with average follow-up time of 12.5 months. Preoperative diagnoses consisted of acute disc herniation (1098), lumbar stenosis (2432), and degenerative spondylolisthesis (229). Demographics, operative details, complications, and perioperative outcome and satisfaction scores were analyzed.ResultsAverage age was 61.32 years, 48% male. 2402 decompressions, 1056 discectomies, and 261 transforaminal lumbar Interbody fusions (TLIFs) were performed. Surgery was performed on 4376 lumbar levels, with L4-5 being most common(61.3%). 290 total complications occurred, 2.23% durotomies, 1.29% inadequate decompressions, 3.79% epidural hematomas, and < 1% transient nerve root injuries, infections, and iatrogenic instability. Significant improvement in VAS-Back, VAS-Leg, ODI, and Macnab Scores were seen across the cohort.ConclusionBiportal spinal endoscopy is a novel method to address pathology in the lumbar spine with direct visualization through an endoscopic approach. Complications are comparable to previously published rates. Clinical outcomes demonstrate effectiveness. Prospective studies are required to assess the efficacy of the technique as compared to traditional techniques. This study demonstrates that the technique can be successful in the lumbar spine.© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.

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