Table II.
Key details of the studies included in the meta-analysis.
| Study | Study type | Country | No. of levels | BESS/MD | BESS/MD (M/F) | Age, years (BESS/MD) | Complications | Conclusion | Final follow-up months | (Refs.) |
|---|---|---|---|---|---|---|---|---|---|---|
| Choi (2019) | Retrospective study | Korea | BSS: Single -24 Multiple levels-11 MD: Single Multiple levels-15 | 35/30 | 14/21:17/13 | 65.4±11.8/ 65.2±12.0 | BESS: Dural tear (n=2) Root injury (n=1) MD: Dural tear (n=2) | BESS produced clinical results not inferior to those of MD in the short-term | 6 | (19) |
| Heo (2018) | Retrospective analysis of prospectively collected data | Korea | All single level | 37/30 | 15/22:12/21 | 66.7±9.4/ 63.4±11.1 | BESS: Durotomy (n=1) Post-operative Hematoma (n=1) MD: Durotomy (n=2) Transient weakness (n=1) Post-operative hematoma (n=2) | Uniportal or biportal Endoscopic lumbar approach may be effective for the treatment of lumbar central stenosis and an alternative to conventional MD. | VAS Back: BESS:1.98±0.80 MD: 2.04±0.88 VAS Leg: BESS 2.07±0.77 MD: 2.21±0.95 ODI: BESS 21.98±2.82 MD: 22.59±3.16 | (17) |
| Heo (2018) | Case control prospective study | Korea | All single level | 46/42 | 18/28:16/26 | 65.8±8.9/ 63.6±10.5 | BESS: Durotomy (n=1) Post-operative hematoma (n=1) MD: Durotomy (n=1) Post-operative hematoma (n=2) | BESS is a safe and effective treatment for lumbar spinal stenosis. Decompression rates are similar to those of BESS and MD. | VAS Back: BESS:1.98±0.80 MD: 2.04±0.88 VAS Leg: BESS: 2.07±0.77 MD: 2.21±0.95 ODI: BESS: 21.98±2.82 MD: 22.59±3.16 | (18) |
| Kang (2019) | Randomized controlled trial | Korea | All single level | 32/30 | 18/14: 14/16 | 65.1±8.6/ 67.2±9.5 | BESS: Revision (n=1) MD: Revision (n=1) | BESS resulted in favorable clinical outcomes, less pain and a shorter hospital stay compared to MD. | 6 | (16) |
| Min (2019) | Case control study | Korea | All single level | 54/35 | 27/27: 19/16 | 65.74±10.52/ 66.74±7.96 | BESS: Dural tear (n=2) Post-operative epidural hematoma (n=1) MD: Microsurgery: Dural tear (n=1) Post-operative epidural hematoma (n=1) | Similar outcomes with BESS and MD. However, BESS leads to less postoperative back pain than MD and may allow early ambulation and a shorter hospitalization period. | BESS: 27.2±5.4 MD: 31.5±7.3 | (15) |
| Park (2020) | Randomized controlled trial | Korea | All single level | 32/32 | 13/19:18/14 | 66.2/ 67.1 | BESS: Incidental durotomy (n=2) Symptomatic hematoma with revision surgery (n=1) MD: Incidental duroctomy (n=2) Symptomatic hematoma with revision surgery (n=1) Revision surgery due to recurrent pain (n=1) | BESS is an alternative to MD with similar clinical outcomes. | 12 | (14) |
BESS, biportal endoscopic spine surgery; MD, microscopic decompression; M, males; F, females; n, number of patients; VAS, Visual analogue scale; ODI, Oswestry disability index.