Related Experiment Video
Updated: Sep 12, 2025
Clinical Application of Microscope-Assisted Minimally Invasive Anterior Lumbar Interbody Fusion
Published on: June 16, 2023
Is a Microscope Necessary in Cervical Discectomy to Reduce Neurological Injury?: A Prospective Randomized Control
Mojtaba Khalili1, Mahdi Arjipour1, Mohamadali Seifrabiei2
1Department of Neurosurgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
Objective:
This study aimed to compare the complications and outcomes of macroscopic and microscopic anterior cervical discectomy.
Methods:
In this single-blind randomized clinical trial, 47 patients referred for anterior cervical discectomy and fusion were randomly assigned to two groups: microscopic (n=23) and macroscopic (n=24). Both groups were evaluated and compared regarding 1) complications, including neurological deficits, dural damage, and dysphagia; 2) the amount of intra- and postoperative bleeding; 3) the amount of analgesic administered; 4) length of hospitalization; 5) quality of life before and one month after surgery, using the 12-item short form questionnaire; and 6) time required to return to daily activities.
Results:
Complications and neurological deficits were not significantly different between the two groups. Although the preoperative quality of life was not significantly different between the two groups (p=0.458), the microscopic groups had a greater improvement in quality of life after surgery than the macroscopic group (43.04±3.67 vs. 37.84±2.30; p<0.001). However, the microscopic group had a longer surgical duration than the macroscopic group (75.86±9.78 vs. 57.12±2.81 minutes; p<0.001).
Conclusion:
Anterior cervical discectomy with an intraoperative microscope increases the surgical duration but is not significantly different from the macroscopic method in terms of neurological deficits and complications. However, the microscopic method may improve the quality of life of patients compared to the macroscopic method during the short-term follow-up.
Insights
Microscopic anterior cervical discectomy shows similar complication rates but improved quality of life compared to the macroscopic approach. However, microscopic surgery requires a longer operative time.
Area of Science:
- Neurosurgery
- Spinal Surgery
Background:
- Anterior cervical discectomy is a common procedure for cervical spine pathologies.
- Comparing surgical techniques is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare the complications and outcomes of microscopic versus macroscopic anterior cervical discectomy.
- To evaluate the impact of surgical approach on patient quality of life and recovery.
Main Methods:
- A single-blind randomized clinical trial involving 47 patients undergoing anterior cervical discectomy and fusion.
- Patients were allocated to either microscopic (n=23) or macroscopic (n=24) surgical groups.
- Outcomes assessed included complications, bleeding, analgesic use, hospitalization, quality of life (SF-12), and return to daily activities.
Main Results:
- No significant differences in complications or neurological deficits were observed between the microscopic and macroscopic groups.
- The microscopic group demonstrated a significantly greater improvement in quality of life post-surgery (p<0.001).
- Surgical duration was longer in the microscopic group (75.86±9.78 min) compared to the macroscopic group (57.12±2.81 min; p<0.001).
Conclusions:
- Microscopic anterior cervical discectomy does not increase neurological deficits or complications compared to the macroscopic method.
- The microscopic approach may enhance short-term quality of life for patients.
- Increased surgical time is a trade-off for potential quality of life benefits with the microscopic technique.
