Acta Neurochirurgica

, Volume 158, Issue 6, pp 1095–1101 | Cite as

The influence of lunar phases and zodiac sign ‘Leo’ on perioperative complications and outcome in elective spine surgery

  • Holger JoswigEmail author
  • Martin N. Stienen
  • Carolin Hock
  • Gerhard Hildebrandt
  • Werner Surbeck
Clinical Article - Spine



Many people believe that the moon has an influence on daily life, and some even request elective surgery dates depending on the moon calendar. The aim of this study was to assess the influence of ‘unfavorable’ lunar or zodiac constellations on perioperative complications and outcome in elective surgery for degenerative disc disease.


Retrospective database analysis including 924 patients. Using uni- and multivariate logistic regression, the likelihood for intraoperative complications and re-do surgeries as well as the clinical outcomes at 4 weeks was analyzed for surgeries performed during the waxing moon, full moon, and dates when the moon passed through the zodiac sign ‘Leo.’


In multivariate analysis, patients operated on during the waxing moon were 1.54 times as likely as patients who were operated on during the waning moon to suffer from an intraoperative complication (OR 1.54, 95 % CI 1.07–2.21, p = 0.019). In contrast, there was a trend toward fewer re-do surgeries for surgery during the waxing moon (OR 0.51, 95 % CI 0.23–1.16, p = 0.109), while the 4-week responder status was similar (OR 0.73, 95 % CI 0.47–1.14, p = 0.169). A full moon and the zodiac sign Leo did not increase the likelihood for complications, re-do surgeries or unfavorable outcomes.


We found no influence of ‘unfavorable’ lunar or zodiac constellations on the 4-week responder status or the revision rate that would justify a moon calendar-based selection approach to elective spine surgery dates. However, the fact that patients undergoing surgery during the waxing moon were more likely to suffer from an intraoperative complication is a surprising curiosity and defies our ability to find a rational explanation.


Complications Lunar phase Moon phase Neurosurgery Spine surgery Superstition 



The authors thank Dario Jucker, medical student at the University of Zurich, for helping with the data acquisition. We thank Dr. Nicolas Smoll for his advice on the statistical part of the manuscript. Figure 1 was obtained from the Abbey Library of St. Gallen (UNESCO World Heritage Site). We thank U5 for editing Fig. 2.

Compliance with ethical standards


No funding was received for this study.

Conflict of Interest


Ethical approval

For this type of study formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • Holger Joswig
    • 1
    Email author
  • Martin N. Stienen
    • 2
  • Carolin Hock
    • 1
  • Gerhard Hildebrandt
    • 1
  • Werner Surbeck
    • 1
  1. 1.Department of NeurosurgeryCantonal Hospital St. GallenSt. GallenSwitzerland
  2. 2.Department of Neurosurgery and Faculty of MedicineUniversity Hospital GenevaGenevaSwitzerland

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