Meaningful outcome research to validate endoscopic treatment of common lumbar pain generators with durability analysis
Endoscopic treatment of common degenerative spinal conditions with simplified, less costly, and more effective treatments has been belittled and poorly accepted by traditionally trained spine surgeons. One of the leading reasons often cited is the lack of high-grade clinical evidence to favor it over traditional open or other types of minimally invasive translaminar surgeries. The burden of proof, therefore, lies with surgeons advocating for its implementation. The claim that targeted endoscopic treatment of common spinal pain generators produces higher patient satisfaction than with traditional spine surgery still lacks support by statistically validated prognosticators of favorable outcomes with the endoscopic procedure for most surgical indications. In this editorial, the authors discuss the difficulties with orchestrating meaningful spinal outcome research studies and how some of them could be overcome with straightforward survival analysis of the endoscopic spinal surgery treatment benefit.