The role of surgeon experience on operative outcomes in cervical and lumbar spine surgery

PURPOSE: To evaluate the association between surgeon experience, defined by post-fellowship years in practice, and perioperative outcomes for lumbar laminectomy, discectomy, and anterior cervical discectomy and fusion (ACDF). Although surgeon experience is recognized as an important factor in surgical outcomes, its role in common spine procedures remains unclear. METHODS: We retrospectively reviewed patients from three institutions (2013-2023) undergoing single or two-level laminectomy, discectomy, or ACDF. Surgeons were grouped as early-career (< 5 years), mid-career (5-10 years), or late-career (≥ 11 years). Outcomes included operative time, extended length of stay (LOS), neurologic deficits, and revision within two years. Multivariable logistic regression adjusted for demographics, comorbidities, and procedure type. RESULTS: Among 1,660 patients, late-career surgeons had significantly lower odds of extended operative time than early-career surgeons (OR 0.41, 95% CI 0.28-0.62, p < 0.001), particularly in discectomy (OR 0.17, 95% CI 0.09-0.34, p < 0.001). They also demonstrated reduced odds of extended LOS for discectomy (OR 0.36, 95% CI 0.15-0.89, p = 0.03). In contrast, mid- and late-career surgeons had higher odds of revision overall (OR 1.85, p = 0.047; OR 2.05, p = 0.01), with the effect most pronounced in discectomy (OR 3.72 and 4.05, respectively). No significant associations were observed between surgeon experience and neurologic deficits. CONCLUSIONS: Greater surgeon experience was associated with shorter operative time and, in some cases, shorter LOS. However, greater experience was also associated with a higher risk of revision, particularly in lumbar discectomy. No statistically significant association was observed between surgeon experience and neurologic outcomes after adjustment.