ArticleAsian spine journal2025
Biportal endoscopic versus conventional open spine surgery for lumbar degenerative disease: a systematic review and meta‑analysis.
Article in Asian spine journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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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.
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.
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Who cites it
9 citing papers in PubMed.
- Comparison of paraspinal muscle changes after biportal endoscopic and microscopic lumbar discectomy or decompression.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Biportal Endoscopic Transforaminal Lumbar Interbody Fusion for Two-Level Fusion: Hemodynamic Profiles and Early Clinical Outcomes Compared with Tubular MIS and Open Approaches.Journal of clinical medicine · 2026Article
- Article
- Benchmarking deep learning pipelines for surgical instrument segmentation in endoscopic spine surgery: cross-dataset evaluation under deployment-realistic conditions.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Domain-Adapted Foundation Models for Single-Click Surgical Instrument Segmentation in Spinal Endoscopy.Neurospine · 2026Article
- A Systematic Review of Complication Management During Uniportal and Biportal Endoscopic Spine Surgery: Dural Tear and Bleeding.Global spine journal · 2026Article
- Symptomatic adjacent-segment epidural hematoma after UNSES for L4/5 lumbar disc herniation: a case report and narrative literature review.Frontiers in surgery · 2026Article
- Response to the letter to the editor: Clarification regarding effect size reporting in "biportal endoscopic versus conventional open spine surgery: a systematic review and meta-analysis".Asian spine journal · 2025Article
- Letter to editor: Clarification regarding effect size reporting in "biportal endoscopic versus conventional open spine surgery: a systematic review and meta-analysis".Asian spine journal · 2025Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This study was the first comprehensive systematic review and meta-analysis to compare clinical outcomes between conventional open surgery and biportal endoscopy for decompression and fusion of lumbar degenerative disease. Although conventional open spine surgery has been the standard approach for decades, biportal endoscopy has gained attention as a minimally invasive alternative with potential surgical outcome benefits. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we performed a systematic review and meta-analysis including eight comparative studies on open and biportal endoscopic spine surgery. A comprehensive search of PubMed, Embase, and Scopus identified studies that reported outcomes, such as the Oswestry Disability Index (ODI), Visual Analog Scale (VAS) scores for back and leg pain, complication rates, operative time, and hospital stay. Data were analyzed using a random effects model to evaluate the effect size between the two approaches. We analyzed 414 open and 383 biportal endoscopic lumbar surgical procedures. The open group had a mean age of 61.0 years and comprised 42.0% men, whereas the biportal group had a mean age of 59.8 years and comprised 46.7% men. Compared with open spine surgery, biportal surgery was associated with a significantly longer operative time but shorter length of hospital stay and similar preoperative VAS scores, ODI score, and postoperative outcomes at <1 month and >1 year. Fusion subgroup analysis showed significantly lower VAS score for back pain with biportal surgery than with open surgery, but the other measures were comparable. Despite its longer operative time, biportal endoscopy led to shorter hospital stay and similar long-term pain and disability outcomes, compared with open spine surgery. Given the significant improvement in short-term leg pain relief after fusion procedures, biportal endoscopic spine surgery is a potential minimally invasive alternative to open surgery that warrants further study.
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