Comparison of endoscopic and non-endoscopic lumbar decompression outcomes using ACS-NSQIP database 2017-2022

Area of Science:

• Neurosurgery
• Minimally Invasive Surgery
• Spine Surgery

Background:

• Endoscopic decompressive laminectomy is emerging as an alternative to traditional spine surgery.
• This technique potentially offers smaller incisions and reduced complication risks.
• Comparison with open or minimally invasive (MIS) laminectomy is crucial.

Purpose of the Study:

• To compare patient characteristics and adverse outcomes between endoscopic and open/MIS laminectomy.
• To evaluate the safety and efficacy of endoscopic lumbar decompression.
• Utilize the American College of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) database.

Main Methods:

• Analysis of ACS-NSQIP data from 2017-2022.
• Inclusion of single-level lumbar decompression cases using specific Current Procedural Terminology (CPT) codes.
• Comparison of 336 endoscopic cases with 55,111 non-endoscopic cases.

Main Results:

• Endoscopic patients experienced fewer total adverse outcomes post-surgery (1.2% vs. 4.8%, P=0.01) after propensity score adjustment.
• Significantly lower rates of blood transfusions were observed in the endoscopic group (P<0.05).
• Key patient demographics and comorbidities were balanced between groups.

Conclusions:

• Endoscopic lumbar decompression is associated with significantly lower adverse event rates.
• The technique demonstrates a reduced need for blood transfusions compared to traditional methods.
• Findings support the growing body of evidence favoring endoscopic spine surgery.