Full-endoscopic surgery in spinal oncology: a systematic review of clinical efficacy and outcomes.

Background: Spinal tumors present complex clinical challenges due to their proximity to vital neurological structures. Conventional open surgery may be associated with notable complications, contributing to a growing interest in minimally invasive approaches. This systematic review explored the role, safety, and effectiveness of full-endoscopic spine surgery in managing spinal tumors. Methods: A thorough literature search was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across PubMed, EMBASE, and CINAHL databases. Recent studies describing full-endoscopic spinal tumor procedures and clinical outcomes, including pain relief, neurological improvement, surgical complications, and recovery metrics, were selected. Results: Ten studies involving 65 patients, all retrospective case series or case reports, met the inclusion criteria. Most of the procedures involved gross total tumor resection with various endoscopic approaches. Postoperative outcomes demonstrated significant reductions in pain scores and improvement or stability in neurological function across nearly all patients. The average surgery duration was 121 minutes, estimated blood loss ranged from minimal to 100 mL, and hospital stays averaged 71 hours. Complication rates following full-endoscopic spinal surgeries were low and primarily transient, and no tumor recurrences or reoperations were noted within the follow-up period averaging 16.4 months. Conclusions: Full-endoscopic spine surgery appears to be a relatively safe and effective minimally invasive technique that is being increasingly adopted for selected spinal tumors. Preliminary evidence suggests a favorable safety profile, including reduced surgical trauma, decreased blood loss, shortened hospital stays, as well as accelerated recovery. Nevertheless, its broader use remains limited by the steep learning curve for spine surgeons, the rarity of spinal tumors, and a lack of larger prospective studies.