Anterior cervical spine surgical complications: Safety comparison between teacher and student

Abstract

Background: Anterior cervical surgery has a widespread use. Despite its popularity, this surgery can lead to serious and life-threatening complications, and warrants the attention of skilled attending spinal surgeons with many years of experience. Methods: We retrospectively evaluated postoperative complications occurring in 110 patients who underwent anterior cervical surgery (anterior cervical discectomy without fusion, anterior cervical discectomy and fusion, and anterior cervical disc arthroplasty) between 2013 and 2020. These operations were performed by an either an attending surgeon with 30 years' experience versus a novice neurosurgeon (NN) with <5 years of training with the former surgeon. Complications were variously identified utilizing admission/discharge notes, surgical reports, follow-up visits, and phone calls. Complications for the two groups were compared for total and specific complication rates (using the Pearson's Chi-square and Fisher's test). Results: The total cumulative complication rate was 15.4% and was not significantly different between the two cohorts. The most frequent postoperative complication was dysphagia. Notably, there were no significant differences in total number of postoperative instances of dysphagia, dysphonia, unintended durotomy, hypoasthenia, and hypoesthesia; the only difference was the longer operative times for NNs. Conclusion: Surgeons' years of experience proved not to be a critical factor in determining complication rates following anterior cervical surgery.