Complications in Minimally Invasive Spine Surgery (2013–2024)
Bibliographic record
Abstract
STUDY DESIGN: Systematic review and proportional meta-analysis. OBJECTIVE: To evaluate overall and specific complication rates associated with lumbar uniportal endoscopic spine surgery (UESS) over the past decade. SUMMARY OF BACKGROUND DATA: UESS offers reduced tissue damage, faster recovery, and improved outcomes for lumbar spinal pathologies. However, its steep learning curve may contribute to variable complication rates, reported between 0% and 30%, highlighting the need for a pooled analysis. METHODS: We registered this review in the International Prospective Register of Systematic Reviews (CRD42024570377). We systematically searched PubMed, Medline, Embase, and Cochrane Library (January 2013-March 2024) following PRISMA guidelines. Studies with at least 10 adult patients that reported UESS complication rates were included. Conference abstracts, reviews, meta-analyses, non-English studies, and studies using micro-endoscopic, lateral, or oblique approaches were excluded. A random-effects model was used to pool complication rates. Study quality was assessed using the Cochrane Risk of Bias Tool and Newcastle-Ottawa Scale. Analyses were conducted with R Studio. RESULTS: Twenty-one studies with 1258 patients were included. Most studies were high quality and retrospective, with one randomized controlled trial. The patient's age ranged from 41.6 to 73.5 years, with 38.7% male, and follow-up periods between 6 and 26.5 months. The studies mainly focused on lumbar spinal stenosis treatment and were primarily conducted in China and Korea. The total 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%). Total complication rates showed significant heterogeneity (I²=65.5%), whereas specific complications had low to moderate heterogeneity. CONCLUSIONS: Lumbar UESS demonstrated a 9.79% overall complication rate, with dural tears and nerve palsy being the most common. Despite UESS being generally safe, complication variability highlights the need for better patient selection and long-term outcome research.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.037 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.018 | 0.045 |
| Bibliometrics | 0.010 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".