Full endoscopic and microsurgical decompression methods for spinal canal stenosis at the lumbosacral level: a systematic review

Degenerative stenosis of the lumbosacral region is a common cause of chronic pain and disability. Microsurgical decompression remains the standard of treatment, but fully endoscopic methods are being actively introduced as a less invasive alternative. The purpose of the study. To conduct a systematic review of the literature and compare the efficacy and safety of fully endoscopic and microsurgical decompression in degenerative spinal canal stenosis. Materials and methods. The systematic search (2015-2025) was performed according to PRISMA 2020. The analysis included 6 studies with the number of Postoperative pain (VAS), functional status (ODI), blood loss, duration of surgery, and complication rate were assessed. The quality of the work was assessed on the Newcastle-Ottawa Scale. Results. Endoscopic decompression provided lower pain intensity in the early postoperative period (p < 0.001). After 6 months, there were no differences in YOUR and ODI between the methods. Endoscopic surgeries were characterized by lower estimated blood loss, but longer duration of intervention. The frequency of TMO injuries and infections was comparable between the groups. Conclusion. Endoscopic decompression is a safe and clinically comparable alternative to microsurgery, with advantages in the early postoperative period. The method can be considered as a promising minimally invasive option for spinal canal stenosis.