Study design: Systematic review and meta-analysis. Objective: This meta-analysis aims to systematically assess clinical and surgical outcomes of endoscopic spine surgery for cauda equina syndrome (CES). Summary of Background Data: Endoscopic spine surgery has emerged as a minimally invasive alternative for CES treatment, yet its efficacy and safety remain uncertain. Methods: A systematic search of PubMed, Embase, and Web of Science was conducted in accordance with PRISMA guidelines. Continuous outcomes were analyzed as pooled means with 95% CIs, while dichotomous outcomes were pooled using a generalized linear mixed-effects model. Pooled estimates were calculated using random-effects models in R software (version 4.5.1). Results: Seven studies (n=107) were included. The mean operative time was 55.6 minutes (95% CI: 42.0–73.5), with an estimated blood loss of 11.9 mL (95% CI: 1.2–118) and a hospital stay of 2.33 days (95% CI: 0.86–6.35). The overall complication rate was 7% (95% CI: 1.3–29.8) and the reoperation rate 4.5% (95% CI: 0.7–24.3). Postoperative outcomes demonstrated pooled mean reductions of –5.7 points in visual analog scale (VAS) Back (95% CI: –8.5 to –2.8), –7.7 points in VAS Leg (95% CI: –9.5 to –5.9), and a –57.7 percentage-point decrease in Oswestry Disability Index (95% CI: –74.0 to –41.4). Neurological recovery was also favorable, with pooled recovery rates of 78.3% for motor function (95% CI: 53.6–91.8), 67% for saddle anesthesia (95% CI: 34–89), and 97.8% for bladder/bowel function (95% CI: 15.8–100). Conclusions: Endoscopic spine surgery provides a safe and effective minimally invasive option for CES. Future prospective studies are warranted to further validate its long-term efficacy and safety.
Lobo et al. (Fri,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: