• Emir Begagić, Ragib Pugonja, Hakija Bečulić, Edin Selimović, Rasim Skomorac, Benjamin Saß, and Mirza Pojskić.
• Department of General Medicine, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina. Electronic address: begagicem@gmail.com.
• World Neurosurg. 2024 Feb 1; 182: 144158.e1144-158.e1.

BackgroundThe growing interest in exoscopic (EX) technology has prompted a comprehensive evaluation of its clinical, functional, and financial outcomes in neurosurgery. This systematic review and meta-analysis aimed to explore the utilization of EX in spine surgery and assess their safety, efficacy, and impact on surgical outcomes.MethodsA thorough literature review was conducted using PubMed, Scopus, and Embase databases in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study focused on articles concerning the application of EXs in spinal surgical procedures. The inclusion criteria encompassed various study designs presenting clinical data and intraoperative experiences related to EX utilization in spine surgery.ResultsThe meta-analysis included studies examining various aspects of EX utilization, such as intraoperative complications, video/image quality, surgical field visualization, ease of manipulation, ergonomic characteristics, educational utility, surgical duration, and team involvement. Findings indicated that EXs offered superior video quality and favorable ergonomic features. Comparable outcomes were observed in surgical duration, intraoperative blood loss, time to discharge, and postoperative pain levels between EX and conventional microscope approaches.ConclusionsThis study provides valuable insights into the utilization of EXs in spine surgery, demonstrating their potential advantages and comparable outcomes with conventional microscopes.Copyright © 2023 Elsevier Inc. All rights reserved.

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