The relationship between surgeon experience, complications, and radiographic outcomes in spine deformity surgery: the experience of a junior surgeon

Document Type

Journal Article

Publication Date



World neurosurgery




adult spine deformity; complications; outcomes; surgeon experience


OBJECTIVE: To examine complication rates and radiographic outcomes in patients undergoing surgery for adult spinal deformity by a junior surgeon. METHODS: A study was conducted of a retrospective cohort of patients who underwent an open posterior interbody fusion of the thoracic and/or lumbar regions by a single surgeon for adult spinal deformity (ASD) between 2018 and 2022. Patient characteristics, complications, and common radiographic parameters of spinopelvic alignment were collated. RESULTS: 112 patients with an average of 4.2 comorbidities underwent surgical correction of ASD. 37 patients (33.0%) experienced 52 major complications and 50 patients (44.6%) experienced 66 minor complications. 23 patients (20.5%) required a revision operation. Both sagittal vertical axis (p < 10) and pelvic incidence-lumbar lordosis mismatch (p < 10) significantly improved postoperatively. Number of levels (p < 0.05), operative time > 650 minutes (p < 0.01), estimated blood loss > 1500mL (p < 0.01), length of ICU stay > 1 day (p < 0.05), and hospitalization length > 5 days (p < 0.05) all significantly increased the risk of a major complication. No patient factors significantly increased the risk of minor complications or revision surgery. CONCLUSION: Observed complication and revision rates in this cohort were consistent with rates published in the literature. No pre-operative patient risk factors significantly increased risk of complications or need for revision, suggesting that no patient population is at increased risk undergoing surgery by a junior surgeon. The relatively high rate of complications observed in this cohort may be due to high baseline morbidity.


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