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Complications in Minimally Invasive Spine Surgery (2013-2024): A Proportional Meta-Analysis -Uniportal Endoscopic
Sean Inzerillo1, Chibuikem A Ikwuegbuenyi2, Eesha Gurav3
1College of Medicine, SUNY Downstate Health Sciences University, New York, NY.
Spine
|February 12, 2026
Summary
Lumbar uniportal endoscopic spine surgery (UESS) has an overall complication rate of 9.79%. Dural tears and nerve palsy are the most frequent complications, indicating a need for improved patient selection and further research.
Area of Science:
- Minimally invasive spine surgery techniques.
- Spinal surgery outcomes and complication analysis.
Background:
- Lumbar uniportal endoscopic spine surgery (UESS) offers benefits like reduced tissue damage and faster recovery.
- However, UESS has a steep learning curve, potentially leading to variable complication rates (0-30%).
Purpose of the Study:
- To systematically evaluate the overall and specific complication rates of lumbar UESS over the past decade.
Main Methods:
- A systematic review and proportional meta-analysis were conducted, searching major databases (PubMed, Medline, Embase, Cochrane Library) from January 2013 to March 2024.
- Included studies involved at least 10 adult patients undergoing lumbar UESS, excluding specific approaches and study types.
- A random-effects model was used to pool complication rates, with study quality assessed using established tools.
Main Results:
- Twenty-one studies with 1258 patients were included, primarily focusing on lumbar spinal stenosis.
- The overall pooled complication rate was 9.79% [95% CI (7.00%, 13.53%)].
- Specific complication rates included dural tears (3.75%), nerve palsies (2.69%), postoperative hematomas (0.24%), surgical site infections (0.01%), and surgical revisions (2.39%).
Conclusions:
- Lumbar UESS shows a 9.79% overall complication rate, with dural tears and nerve palsy being most common.
- While generally safe, the variability in complications underscores the need for optimized patient selection and further investigation into long-term outcomes.
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