Endoscopic Spine Surgery vs. Conventional Approaches for Lumbar Spondylolisthesis: Systematic Review and...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Minimally Invasive Surgery

Background:

• Lumbar spondylolisthesis treatment often involves surgical intervention.
• Comparing endoscopic spine surgery (ESS) with traditional non-ESS approaches is crucial for optimizing patient outcomes.
• Evaluating clinical, radiologic, and perioperative results is essential for evidence-based decision-making.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy of ESS versus non-ESS surgical strategies for lumbar spondylolisthesis.
• To compare clinical outcomes, including pain and disability, between ESS and non-ESS.
• To assess radiologic and perioperative differences, such as fusion rates, blood loss, and hospital stay.

Main Methods:

• A PRISMA-guided systematic review and meta-analysis was conducted.
• Searches included PubMed, Web of Science, Scopus, and CENTRAL up to December 2025.
• Included 18 studies (1200 patients) comparing ESS with non-ESS for lumbar spondylolisthesis.

Main Results:

• No significant differences were found in VAS back/leg pain or Oswestry Disability Index (ODI) between ESS and non-ESS.
• Radiologic outcomes (disc height, lordosis angle, fusion rate) showed no statistically significant differences.
• ESS was associated with reduced blood loss and shorter hospital stay, but not operative time or complications.

Conclusions:

• ESS and non-endoscopic approaches for lumbar spondylolisthesis yield comparable clinical, radiologic, and complication outcomes.
• Potential perioperative benefits of ESS include decreased blood loss and shorter hospital stays.
• Findings should be interpreted cautiously due to the predominantly retrospective and heterogeneous nature of the included studies.