Introduction: Complex anterior cervical discectomy and fusion (ACDF) procedures present significant challenges, particularly for surgeons early in their careers. With intricate anatomical considerations and potential complications, novice surgeons must navigate a steep learning curve to achieve proficiency in this demanding surgical technique. This presentation aims to explore the experiences of beginner surgeon undertaking complex ACDF procedures, examining their approach, outcomes, and the learning curve associated with this specialized surgical intervention.

Materials: Patients were operated on by a beginner neurosurgeon, with less than three years of experience in performing ACDF procedures. Complex cases were identified based on predefined criteria, including multilevel pathology, extensive vertebral involvement, and comorbidities complicating the surgical approach.

Methods: A retrospective analysis was conducted to evaluate surgical outcomes, including operative time, intraoperative complications, postoperative complications, and patient-reported outcomes at 3 and 6 months follow-up. Surgeon-specific data, such as training background and case volume, were also examined to assess their impact on procedural success and complication rates.

Results: The study identified a total of 13 complex multilevel ACDF procedures performed by young neurosurgeon during period of 9 months. Mean operative time was 3 hours, with no intraoperative complications. Postoperative complications occurred in 15% of patients, with the most common being dysphagia and transient hoarseness. Patient-reported outcomes revealed satisfactory pain relief and functional improvement in 84% of cases at the latest follow-up.

Discussion: Young neurosurgeons face unique challenges when undertaking complex ACDF procedures, including technical proficiency, decision-making under pressure, and complication management. The learning curve associated with these procedures is steep, requiring deliberate practice, mentorship, and ongoing skill development. Conclusion: With appropriate training, young neurosurgeons can achieve satisfactory surgical outcomes, emphasizing the importance of mentorship and ongoing professional development in surgical practice. Further research is needed to refine training strategies and enhance the safety and efficacy of complex ACDF procedures for surgeons at all stages of their careers.