In Brief:
Increasing case number corresponded with increases in total screws placed, improvements in curve correction, length of stay, blood loss, transfusion rate, operative times, and significant reductions in minutes/screw, suggesting a significant learning curve effect in thoracic pedicle screws. Loss of T2–T12 kyphosis with increasing case number and higher implant density reflects the difficulty in maintaining kyphosis with all-screw constructs using, 5.5 mm rods.