Early Postoperative Adverse Events Following Multi-Level Posterior Segmental Spinal Instrumentation: A Decade-Spanning Retrospective Analysis

BACKGROUND: Multi-level posterior segmental spinal instrumentation procedures have increased considerably in recent decades; however, short-term findings remain incompletely generalized. Therefore, this study investigates 30-day outcomes following these procedures to better highlight profiles and associations. METHODS: The ACS-NSQIP database (2014-2023) was queried for patients undergoing multi-level posterior segmental instrumentation. Cases with missing variables or select complexity-increasing add-ons were excluded. A composite any adverse event (AAE) variable was examined, alongside various other complication subgroupings. Statistics included descriptive transformations, multivariable logistic regressions, and threshold analyses, where appropriate. RESULTS: percentile) corresponded to increased AAE odds (corrected p<0.001), rising from 16% below to 42% above. CONCLUSIONS: In this decade-spanning analysis, multi-level posterior segmental spinal instrumentation demonstrated meaningful short-term complication rates. Targeted preoperative counseling and facilitation of timely operative intervention may be warranted, and future studies should further evaluate these associations.