Intra- and Perioperative Complications Associated with Endoscopic Spine Surgery: A Multi-Institutional Study

Objective To report on intra- and perioperative complications associated with working channel endoscopic spine surgery. Methods This study is a retrospective chart review of a multi-institutional patient cohort operated on by surgeons within the Endoscopic Spine Study Group between May 2010 and June 2017. Results Our study cohort consists of a total of 553 consecutive cases with an average age of 57 years. The most common procedure was an endoscopic discectomy ( n  = 377, 68%) followed by foraminotomy ( n  = 156, 28.2%), unilateral laminotomy for bilateral decompression ( n  = 55, 9.9%), and lateral recess decompression ( n  = 29, 5.2%). Overall, the rate of intra- and perioperative complications was 2.7%. There were 3 durotomies (0.54%), 2 epidural hematomas (0.36%), 2 patients developed a complex pain disorder (0.36%), 4 recurrent disc herniations within 3 months (1.1%), 4 systemic complications (1.1%), and no wound infections. No risk factors were identified with regards to age, sex, approach, or number of segments. Conclusions Endoscopic spine surgery is associated with a favorable rate of intra- and perioperative complications compared with reported rates of minimally invasive ortraditional open spine surgeries. Our report proposes safe and effective strategies for management of these complications.