A systematic review of biportal endoscopic spinal surgery with interbody fusion
Biportal endoscopic spinal surgery (BESS) with interbody fusion is a relatively novel minimally invasive technique that was developed to reduce soft tissue trauma and intraoperative blood loss and shorten recovery time while achieving comparable clinical outcomes for lumbar degenerative diseases. De...
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2025-04-01
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| Series: | Asian Spine Journal |
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| Online Access: | http://asianspinejournal.org/upload/pdf/asj-2024-0425.pdf |
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| author | Wongthawat Liawrungrueang Ho-Jin Lee Sang Bum Kim Sang-Min Park Watcharaporn Cholamjiak Hyun-Jin Park |
| author_facet | Wongthawat Liawrungrueang Ho-Jin Lee Sang Bum Kim Sang-Min Park Watcharaporn Cholamjiak Hyun-Jin Park |
| author_sort | Wongthawat Liawrungrueang |
| collection | DOAJ |
| description | Biportal endoscopic spinal surgery (BESS) with interbody fusion is a relatively novel minimally invasive technique that was developed to reduce soft tissue trauma and intraoperative blood loss and shorten recovery time while achieving comparable clinical outcomes for lumbar degenerative diseases. Despite the growing interest in BESS, a comprehensive analysis of its effectiveness, complication rates, and long-term outcomes remains lacking. This systematic review evaluated the clinical outcomes, surgical efficacy, and complication rates of BESS with interbody fusion for lumbar degenerative diseases. Recent literature on endoscopic lumbar interbody fusion was included to expand the scope and gain new perspectives, thereby, providing a comparative analysis that highlighted the advantages, limitations, and emerging trends in minimally invasive spine surgery. This review synthesized current evidence to guide future research and clinical applications. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and using a combination of MeSH (Medical Subject Headings) terms and relevant keywords, PubMed/Medline and Scopus databases were systematically searched for studies published between January 2000 and September 2024. The studies were assessed using the ROBINS-I (Risk of Bias in Non-randomized Studies of Interventions) tool to determine the risk of bias. From the 12 studies that provided clinical evidence, the data extracted were patient demographics; operative time; blood loss; clinical outcomes, such as Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores and fusion rates; and complications. The mean operative time ranged from 98 to 206 minutes, with fusion rates between 70% and 95%. Most studies reported significant improvements in VAS scores for back and leg pain and ODI scores. Complications, including dural tears (2.9%–6.4%) and hematomas (1.4%–4.3%), were infrequent but notable. BESS with interbody fusion demonstrated excellent clinical outcomes, high fusion rates, and few complications. Although these results are promising, more randomized controlled trials and long-term studies are required to confirm the broader applicability, particularly in more complex or multilevel spinal pathologies. |
| format | Article |
| id | doaj-art-8da3b29c92074b3b98891cbb03bee799 |
| institution | Kabale University |
| issn | 1976-1902 1976-7846 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj-art-8da3b29c92074b3b98891cbb03bee7992025-08-20T03:54:01ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462025-04-0119227529110.31616/asj.2024.04251732A systematic review of biportal endoscopic spinal surgery with interbody fusionWongthawat Liawrungrueang0Ho-Jin Lee1Sang Bum Kim2Sang-Min Park3Watcharaporn Cholamjiak4Hyun-Jin Park5 Department of Orthopaedics, School of Medicine, University of Phayao, Phayao, Thailand Department of Orthopaedic Surgery, Chungnam National University College of Medicine, Daejeon, Korea Department of Orthopaedic Surgery, Chungnam National University College of Medicine, Daejeon, Korea Spine Center and Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Department of Mathematics, School of Science, University of Phayao, Phayao, Thailand Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, KoreaBiportal endoscopic spinal surgery (BESS) with interbody fusion is a relatively novel minimally invasive technique that was developed to reduce soft tissue trauma and intraoperative blood loss and shorten recovery time while achieving comparable clinical outcomes for lumbar degenerative diseases. Despite the growing interest in BESS, a comprehensive analysis of its effectiveness, complication rates, and long-term outcomes remains lacking. This systematic review evaluated the clinical outcomes, surgical efficacy, and complication rates of BESS with interbody fusion for lumbar degenerative diseases. Recent literature on endoscopic lumbar interbody fusion was included to expand the scope and gain new perspectives, thereby, providing a comparative analysis that highlighted the advantages, limitations, and emerging trends in minimally invasive spine surgery. This review synthesized current evidence to guide future research and clinical applications. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and using a combination of MeSH (Medical Subject Headings) terms and relevant keywords, PubMed/Medline and Scopus databases were systematically searched for studies published between January 2000 and September 2024. The studies were assessed using the ROBINS-I (Risk of Bias in Non-randomized Studies of Interventions) tool to determine the risk of bias. From the 12 studies that provided clinical evidence, the data extracted were patient demographics; operative time; blood loss; clinical outcomes, such as Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores and fusion rates; and complications. The mean operative time ranged from 98 to 206 minutes, with fusion rates between 70% and 95%. Most studies reported significant improvements in VAS scores for back and leg pain and ODI scores. Complications, including dural tears (2.9%–6.4%) and hematomas (1.4%–4.3%), were infrequent but notable. BESS with interbody fusion demonstrated excellent clinical outcomes, high fusion rates, and few complications. Although these results are promising, more randomized controlled trials and long-term studies are required to confirm the broader applicability, particularly in more complex or multilevel spinal pathologies.http://asianspinejournal.org/upload/pdf/asj-2024-0425.pdfendoscopylumbar vertebraespinal fusionminimally invasive surgerydegeneration |
| spellingShingle | Wongthawat Liawrungrueang Ho-Jin Lee Sang Bum Kim Sang-Min Park Watcharaporn Cholamjiak Hyun-Jin Park A systematic review of biportal endoscopic spinal surgery with interbody fusion Asian Spine Journal endoscopy lumbar vertebrae spinal fusion minimally invasive surgery degeneration |
| title | A systematic review of biportal endoscopic spinal surgery with interbody fusion |
| title_full | A systematic review of biportal endoscopic spinal surgery with interbody fusion |
| title_fullStr | A systematic review of biportal endoscopic spinal surgery with interbody fusion |
| title_full_unstemmed | A systematic review of biportal endoscopic spinal surgery with interbody fusion |
| title_short | A systematic review of biportal endoscopic spinal surgery with interbody fusion |
| title_sort | systematic review of biportal endoscopic spinal surgery with interbody fusion |
| topic | endoscopy lumbar vertebrae spinal fusion minimally invasive surgery degeneration |
| url | http://asianspinejournal.org/upload/pdf/asj-2024-0425.pdf |
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