Evidence map›Paper›PMID 38173684›Full record

ReviewWorld neurosurgery: X2024

Comparative analysis of exoscope-assisted spine surgery versus operating microscope: A systematic review.

Javed Iqbal, Michael M Covell, Sidra Jabeen, Abdullah Nadeem, Hamail Malik Gunjial, Hafiz Abdus Saboor, Aamir Amin, Yumna Salman, Muhammad Hassan Hafeez, Christian A Bowers

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in World neurosurgery: X, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
8.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.

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  3. Prospective evaluation of the VITOM 3D exoscope in ear surgery compared with surgical microscopes: part II-optical performance, handling, workload and ergonomics.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 3 countries.

Javed IqbalKing Edward Medical University, Lahore, Pakistan.
Michael M CovellSchool of Medicine, Georgetown University, Washington, DC, USA.
Sidra JabeenLiaquat National Hospital and Medical College, Karachi, Pakistan.
Abdullah NadeemDow University of Health Sciences, Karachi, Pakistan.
Hamail Malik GunjialKing Edward Medical University, Lahore, Pakistan.
Hafiz Abdus SaboorKing Edward Medical University, Lahore, Pakistan.
Aamir AminGuy's and St Thomas' NHS Foundation Trust, London, UK.
Yumna SalmanDow University of Health Sciences, Karachi, Pakistan.
Muhammad Hassan HafeezShalamar Medical and Dental College Lahore, Pakistan.
Christian A BowersBowers Neurosurgical Frailty and Outcomes Data Science Lab, Sandy, UT, USA.
King Edward Medical University · PKDow University of Health Sciences · PKGeorgetown University · USGuy's and St Thomas' NHS Foundation Trust · GBLiaquat National Hospital · PKShalamar Hospital · PK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Limitations in the operative microscope (OM)'s mobility and suboptimal ergonomics created the opportunity for the development of the exoscope. This systematic review aims to evaluate the advantages and disadvantages of exoscopes and OMs in spine surgery. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic search was conducted in the major research databases. All studies evaluating the exoscopes and/or OMs in spinal procedures were included. Results: There were 602 patients included in the 16 studies, with 539 spine surgery patients, 19 vascular cases, 1 neural pathology case, 19 cranial cases, and 24 tumor pathologies. When examining surgical outcomes with the exoscope, results were mixed. Compared to the OM, exoscope usage resulted in longer operative times in 7 studies, comparable times in 3 studies, and shorter operative times in 3 studies. Two studies found similar lengths of stay (LOS) for both tools, two reported longer LOS with exoscopes, and one indicated shorter hospital LOS with exoscopes. One study reported higher exoscope-related blood loss (EBL), but four other studies consistently showed reduced EBL. In terms of image quality, illumination, dynamic range, depth perception, ergonomics and cost-effectiveness, the exoscope was consistently rated superior, while findings across studies were mixed regarding the optical zoom ratio and mean scope adjustment (MSA). The learning curve for exoscope use was consistently reported as shorter in all studies. Conclusion: Exoscopes present a viable alternative to OMs in spine surgery, offering multiple advantages, which supports their promising role in modern neurosurgical practice.

Indexed as

ErgonomicsExoscope-assisted spine surgeryMinimally invasive surgeryNeurosurgical practiceOperating microscopeOptical qualitySurgical outcomes

Identifiers

PMID38173684
PMCPMC10762452
OpenAlexW4389514437

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.