Background: The purpose of this study was to evaluate the trends in adult spinal cases performed by E-Da hospital graduating neurological surgery residents, then comparing the case volumes against the national means in the US. Materials and Methods: The E-Da surgical case volumes were extracted using the hospital billing system for the years 2008–2017. These logs were coded according to the Accreditation Council for Graduate Medical Education guideline, providing a fair comparison against US national means. Linear regression analyses were conducted to identify changes in spinal categories. Finally, an unpaired student t-test was performed to compare E-Da case volumes to America's national means. Results: An average of 781.5 total spinal procedures were performed in the past 4 years of residency training for each of the four graduated E-Da neurosurgical residents, with the individual total caseload increasing by 38.07 cases each year (r2 = 0.40). The US national average was 427.72 spinal procedures for each of the 877 graduating residents, increasing by 19.96 cases every year (r2 = 0.95). E-Da has significantly more thoracic/lumbar instrumentation fusion procedures (mean 486.00 ± 90.27) and anterior cervical approach for decompression/stabilization and fusion procedures (mean 182.75 ± 42.91) than the US (means 145.95 ± 3.07 and 72.66 ± 4.62, respectively). The US has significantly more lumbar discectomy procedures (mean 125.70 ± 2.89), posterior cervical approach for decompression/stabilization and fusion procedures (mean 56.98 ± 3.73) and peripheral nerve procedures (mean 26.2 ± 0.79) than E-Da (means 64.5 ± 8.54, 39.75 ± 4.99, and 8.50 ± 5.07, respectively). Conclusion: Neurosurgical residents' surgical case exposures to different spinal categories were very different in E-Da and the US. Case entry logs provide valuable information nationally and internationally.