Evidence map›Paper›PMID 41721128›Full record

ArticleNeurosurgical review2026

Endoscopic versus open lumbar decompression: a retrospective cohort study of 31,000 patients with 90-day follow-up.

Rohit Srinivas, Rohan Phadke, Samer Salman, Dana Hazem, Harlene Kaur, Rahul Kumar, Swapna Vaja, Nathan J Lee

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Neurosurgical review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
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

9 citing papers in PubMed.

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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

8 authors.

Rohit SrinivasSchool of Medicine, University of Texas at Southwestern, Dallas, TX, USA.
Rohan PhadkeSchool of Medicine, Baylor College of Medicine, Houston, TX, USA.
Samer SalmanSchool of Medicine, Baylor College of Medicine, Houston, TX, USA.
Dana HazemGeisel School of Medicine at Dartmouth, Hanover, NH, USA.
Harlene KaurT.H. Chan School of Medicine, UMass Chan Medical School, Worcester, MA, USA.
Rahul KumarT.H. Chan School of Medicine, UMass Chan Medical School, Worcester, MA, USA. rahul.kumar5@umassmed.edu.ORCID http://orcid.org/0000-0001-8574-2895
Swapna VajaDepartment of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
Nathan J LeeDepartment of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Endoscopic lumbar decompression has emerged as a minimally invasive alternative to open decompression for degenerative lumbar disease. Although prior work suggests potential recovery benefits, large-scale data comparing safety outcomes remain limited. This study compared 90-day complications, reoperation, and healthcare utilization between endoscopic and open lumbar decompression using a national database. We performed a retrospective cohort study using the TriNetX U.S. Research Network. Adults undergoing lumbar decompression were identified using procedure codes for percutaneous endoscopic decompression or discectomy versus conventional open decompression. Primary outcomes were incidental durotomy, cerebrospinal fluid (CSF) leak or pseudomeningocele, and unplanned reoperation. Secondary outcomes included emergency department revisit, readmission, meningitis, wound disruption, venous thromboembolism, and myocardial infarction. Propensity score matching was performed 1:1 using demographic and clinical covariates. After matching, 31,408 patients were included in each cohort. Rates of incidental durotomy were similar between endoscopic and open decompression (0.4% vs. 0.4%). Endoscopic decompression was associated with lower rates of cerebrospinal fluid leak or pseudomeningocele (0.3% vs. 0.5%) and unplanned reoperation (0.2% vs. 1.8%). Overall, healthcare utilization did not differ significantly between cohorts (6.3% vs. 6.1%). However, meningitis (0.4% vs. 0.2%), deep vein thrombosis (0.7% vs. 0.5%), and myocardial infarction (0.4% vs. 0.2%) occurred more frequently following endoscopic decompression. No significant differences were observed in wound disruption. Endoscopic lumbar decompression was associated with lower 90-day rates of cerebrospinal fluid-related complications and unplanned reoperation, though absolute differences were small. Higher rates of meningitis, venous thromboembolism, and myocardial infarction were observed in the endoscopic cohort, while overall healthcare utilization and wound-related complications were comparable. Overall, endoscopic decompression appears safe with modest advantages over open surgery.Level of evidence: Level III Retrospective Comparative Cohort Study.

Indexed as

Decompression, SurgicalEndoscopyLumbar VertebraeAdultAgedCohort StudiesFemaleFollow-Up StudiesHumansMaleMiddle AgedPostoperative ComplicationsReoperationRetrospective StudiesTreatment OutcomeDegenerative spine diseaseEndoscopic spine surgeryLumbar decompressionPerioperative complicationsSurgical outcomes

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Registered trials

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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.