ReviewEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Addressing limitations of previous meta-analyses of uniportal versus biportal endoscopic lumbar surgery: an umbrella review and de-duplicated, pathology-stratified meta-analysis.
Review in 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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePrevious meta-analyses of uniportal versus biportal endoscopic lumbar surgery are affected by overlapping primary studies, discordant study-level extraction, and aggregation of pathologies requiring different operative tasks. We appraised the review-level evidence and generated a de-duplicated, pathology-stratified synthesis of operative time, complications, disability, and leg pain.
methodsFive databases were searched for systematic reviews. Primary citations were normalized across reviews, each eligible comparison was included once per outcome, and discordant group allocation, sample size, follow-up, and numerical values were checked against the original primary publication wherever accessible. Random-effects models and meta-regression examined pathology, approach, and country. Review quality, primary-study risk of bias, and certainty were assessed with AMSTAR 2, RoB 2 or the Newcastle-Ottawa Scale, and GRADE, respectively.
resultsFive reviews and 35 analytic comparisons from 34 primary publications were included. Operative time did not differ overall (35 comparisons; 3,338 participants; MD, 0.09 min; 95% CI, - 8.29 to 8.47), but the direction differed by pathology (P < 0.001): the estimate favored shorter uniportal procedures for LDH (13 comparisons; MD, - 17.67 min; 95% CI, - 26.90 to - 8.44; I² = 92.6%) and shorter biportal procedures for LSS (22 comparisons; MD, 10.45 min; 95% CI, 0.73 to 20.17; I² = 98.9%). Complications (OR, 1.44; 95% CI, 0.94 to 2.23), ODI (MD, 1.96; 95% CI, - 0.60 to 4.52), and leg-pain VAS (MD, 0.01; 95% CI, - 0.05 to 0.06) did not differ clinically. Certainty was low to very low.
conclusionDe-duplication and pathology stratification showed that an overall null operative-time estimate may average effects in opposite directions. These findings support possible effect modification by pathology but, given substantial residual heterogeneity and low to very low certainty, do not establish the superiority of either technique for LDH or LSS.
Indexed as
Identifiers
42850346What OpenQuestion holds
Registered trials
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.