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Biportal spinal endoscopy has been successfully applied to lumbar disc herniations and lumbar spinal stenosis. Obesity is associated with increased risk of complications in spine surgery. Few prior studies have investigated the impact of obesity and associated medical comorbidities with biportal spinal endoscopy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This study was a prospectively collected, retrospectively analyzed comparative cohort design. Patients were divided into cohorts of normal body weight (Bone Mass Index (BMI)18.0\u201324.9), overweight (BMI 25.0\u201329.9) and obese (BMI\u2009&gt;\u200930.0) as defined by the World Health Organization (WHO). Patients underwent biportal spinal endoscopy by a single surgeon at a single institution for treatment of lumbar disc herniations and lumbar spinal stenosis. Demographic data, surgical complications, and patient-reported outcomes were analyzed. Statistics were calculated amongst treatment groups using analysis of variance and chi square where appropriate. Statistical significance was determined as p\u2009&lt;\u20090.05.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Eighty-four patients were followed. 26 (30.1%) were normal BMI, 35 (41.7%) were overweight and 23 (27.4%) were obese. Patients with increasing BMI had correspondingly greater American Society of Anesthesiologist (ASA) scores. There were no significant differences in VAS Back, VAS Leg, and ODI scores, or postoperative complications among the cohorts. There were no cases of surgical site infections in the cohort. All cohorts demonstrated significant improvement up to 1\u00a0year postoperatively.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>This study demonstrates that obesity is not a risk factor for increased perioperative complications with biportal spinal endoscopy and has similar clinical outcomes and safety profile as compared to patients with normal BMI. Biportal spinal endoscopy is a promising alternative to traditional techniques to treat common lumbar pathology.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00701-024-06110-1","type":"journal-article","created":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T22:01:41Z","timestamp":1717452101000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Does obesity and varying body mass index affect the clinical outcomes and safety of biportal endoscopic lumbar decompression? 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YPL is a consultant for Globus and receives fellowship support from Globus and Alphatec. SH is a consultant for Alphatec, SI Bone, Seaspine, Lifspine, and receives fellowship support from Alphatec. DYP is a consultant for Alphatec, Nuvasive, Seaspine, Globus, Stryker, receives royalties from Alphatec and Seaspine, and is a strategic board member and receives stock options from Amplify Surgical, a company that supplies endoscopic equipment used in this study. For the remaining authors none were declared.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of Interest"}},{"value":"This research study was conducted retrospectively from data obtained for clinical purposes. We consulted extensively with the Institutional Review Board who determined that our study did not need ethical approval. An IRB official waiver of ethical approval was granted from the IRB. (IRB#22\u2013001674).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not Applicable. Informed consent was not required for inclusion in this study by the IRB given the respective nature of the study. Also, no identifying details, images, or descriptions of the subjects were obtained or included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not Applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"246"}}