Postoperative complications and mechanical outcomes following endoscopic versus open lumbar fusion: A propensity-matched analysis

Background: Endoscopic lumbar fusion has emerged as a minimally invasive alternative to traditional open fusion, yet large-scale comparative evidence on postoperative safety and long-term effectiveness remains limited. This study evaluated national real-world outcomes following endoscopic versus open lumbar fusion. Methods: A retrospective cohort study was performed using the TriNetX US Collaborative Network. Adult patients undergoing endoscopic and open lumbar fusion were identified using ICD-10-PCS codes. Propensity score matching (1:1) generated 2 balanced cohorts (n=23,723 each). Ninety-day medical and surgical complications were compared using odds ratios (ORs) with 95% confidence intervals (CIs). One-year and 2-year pseudoarthrosis, instrumentation failure, and revision surgery were evaluated using risk ratios (RRs) with 95% CIs. Statistical significance was set at p