Pooled analysis of unsuccessful percutaneous biportal endoscopic surgery outcomes from a multi-institutional retrospective cohort of 797 cases

Background Spinal percutaneous biportal endoscopic surgery (PBES) is a minimally invasive surgery; however, it is associated with several poor outcomes. This study aimed to analyze unsuccessful PBES outcomes and verify their relationships with patient satisfaction. Methods From May 2015 to June 2018, PBES was performed at several institutions. Unsuccessful outcomes (reoperation and prolonged hospital stay) due to various reasons (hematoma, lesion recurrence, incomplete decompression, dural tear, instability, ascites, and infection) were analyzed. To verify the relationships between surgical experience and unsuccessful outcomes, the first 50 cases and the later cases were compared. Logistic regression was used to assess the relationships between unsuccessful outcomes and patient dissatisfaction. Results Among 866 patients, 797 cases with 1-year follow-up and complete data were analyzed. In total, 82 patients with unsuccessful outcomes were identified (10.29%). The incidences of hematoma ( p