Related Experiment Video
Updated: Jan 5, 2026
Prone Lateral Minimally Invasive Retropleural Corpectomy Using a Rotatable Radiolucent Jackson Table
Published on: July 3, 2025
Propensity-matched Comparison of Outcomes and Costs After Macroscopic and Microscopic Anterior Cervical Corpectomy
Allen Lin Ho1, Paymon Garakani Rezaii, Arjun Vivek Pendharkar
1Department of Neurosurgery, Stanford University, Stanford, CA.
Study Design:
A retrospective analysis of national longitudinal database.
Objective:
The aim of this study was to examine the outcomes and cost-effectiveness of operating microscope utilization in anterior cervical corpectomy (ACC).
Summary Of Background Data:
The operating microscope allows for superior visualization and facilitates ACC with less manipulation of tissue and improved decompression of neural elements. However, many groups report no difference in outcomes with increased cost associated with microscope utilization.
Methods:
A longitudinal database (MarketScan) was utilized to identify patients undergoing ACC with or without microscope between 2007 and 2016. Propensity matching was performed to normalize differences between the two cohorts. Outcomes and costs were subsequently compared.
Results:
A total of 11,590 patients were identified for the "macroscopic" group, while 4299 patients were identified for the "microscopic" group. For the propensity-matched analysis, 4298 patients in either cohort were successfully matched according to preoperative characteristics. Hospital length of stay was found to be significantly longer in the macroscopic group than the microscopic group (1.86 nights vs. 1.56 nights, P < 0.0001). Macroscopic ACC patients had an overall higher rate of readmissions [30-day: 4.2% vs. 3.2%, odds ratio (OR) = 0.76 (0.61-0.96), P = 0.0223; 90-day: 7.0% vs. 5.9%, OR = 0.82 (0.69-0.98), P = 0.0223]. Microscopic ACC patients had a higher rate of discharge to home [86.6% vs. 92.5%, OR = 1.91 (1.65-2.21), P < 0.0001] and lower rates of new referrals to pain management [1.0% vs. 0.4%, OR = 0.42 (0.23-0.74), P = 0.0018] compared with macroscopic ACC. Postoperative complication rate was not found to be significantly different between the groups. Finally, total initial admission charges were not significantly different between the macroscopic and microscopic groups ($30,175 vs. $29,827, P = 0.9880).
Conclusion:
The present study suggests that the use of the operating microscope for ACC is associated with decreased length of stay, readmissions, and new referrals to pain management, as well as higher rate of discharge to home.
Level Of Evidence:
3.
Insights
The operating microscope in anterior cervical corpectomy (ACC) reduces hospital stay and readmissions, improving patient discharge rates. This study highlights the benefits of microscope use in ACC procedures for better patient outcomes.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Surgical Technology
Background:
- The operating microscope offers enhanced visualization for anterior cervical corpectomy (ACC), potentially improving decompression and reducing tissue manipulation.
- Despite theoretical advantages, studies have yielded mixed results regarding the impact of microscope use on ACC outcomes and cost-effectiveness.
Purpose of the Study:
- To evaluate the clinical outcomes and cost-effectiveness of utilizing an operating microscope during anterior cervical corpectomy (ACC).
Main Methods:
- A retrospective analysis of a national longitudinal database (MarketScan) from 2007-2016 identified patients undergoing ACC with or without microscope use.
- Propensity score matching was employed to create comparable cohorts, followed by a comparison of outcomes and costs.
Main Results:
- Microscope use in ACC was associated with a significantly shorter hospital length of stay (1.56 vs. 1.86 nights) and lower 30-day and 90-day readmission rates.
- Patients undergoing microscopic ACC had higher discharge-to-home rates (92.5% vs. 86.6%) and fewer new pain management referrals (0.4% vs. 1.0%).
- No significant difference was observed in postoperative complication rates or total initial admission charges between the macroscopic and microscopic ACC groups.
Conclusions:
- The use of an operating microscope in anterior cervical corpectomy (ACC) is linked to improved outcomes, including reduced length of stay, fewer readmissions, and a higher likelihood of home discharge.
- Microscope utilization in ACC may lead to better patient recovery trajectories and potentially lower long-term healthcare utilization related to pain management.
More Related Videos
09:51The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
06:55Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020