Does Surgeon Experience Influence Surgical Safety and Patient Satisfaction After Anterior Cervical Discectomy and Fusion? A Prospective Multicenter Comparison Study Between Non-Board-Certified and Board-Certified Spine Surgeons

Study Design Prospective multicenter cohort study. Objective To evaluate the impact of surgeon experience on surgical safety, radiographic outcomes, and patient-reported outcomes (PROMs) following anterior cervical discectomy and fusion (ACDF) in patients with cervical degenerative disc disease (CDDD). Methods This prospective cohort study was conducted at five spine-specialized institutions in Japan. A total of 208 patients with CDDD who underwent ACDF between 2019 and 2022 were enrolled. Procedures were performed by either board-certified spine (BCS) surgeons (n = 150) or non-BCS (NBCS) surgeons (n = 58) under direct BCS supervision. Demographics, surgical variables, radiographic outcomes, and clinical results were compared. Evaluations included surgical duration, estimated blood loss (EBL), complications, cervical alignment and range of motion (ROM), Japanese Orthopaedic Association (JOA) scores, Visual Analog Scale (VAS), JOACMEQ, and SF-36 scores. Results Surgical duration was comparable between groups, but EBL was significantly greater in the NBCS group (20.2 ± 35.0 mL vs 12.2 ± 13.7 mL, P = .020). Complication rates were low and similar. No major adverse events occurred in either group. Cervical alignment was maintained, and ROM slightly decreased postoperatively without intergroup differences. Both groups showed significant neurological improvement. Gains in JOA scores, reductions in VAS scores, and improvements in JOACMEQ and SF-36 scores were comparable. Conclusions ACDF performed by NBCS surgeons under BCS supervision achieved clinical outcomes equivalent to those by BCS surgeons. These findings underscore the effectiveness of structured supervision in ensuring surgical safety and fostering competency in spine surgery.