A 3 Year Review of Spine Surgeries in a New Neurosurgery Centre in an Urban Specialist Health Facility in Southeast Nigeria

Background: The Imo State Specialist Hospital (IMSSH) commenced neurosurgical services in April 2021 and spine procedures in August 2021. This is an audit of spine pathologies surgically managed in the hospital in her first 3 years since spine surgeries were commenced.

Aims: The study aims to look at the pattern of spinal pathologies surgically managed in the hospital from the commencement of spine services, including their age and sex distribution, the pathologies and their spinal distribution.

Methods: Neurosurgery operating room records were utilized to retrieve the case files of all spine patients who had surgical operations at IMSSH from August 2021 to July 2024 (36 months), and these were retrospectively reviewed.

Results: One hundred and fifty-seven (157) spine patients had surgical operations during the study period (an average of 4 spine surgeries per month). The mean age of patients was 54±16.03 years with a male-to-female ratio of 1.7:1. The mean age for male patients was 53±17.18 years while that of female patients was 55±14.05 years. The peak age range at presentation was in the elderly age group, 60 – 79 years (n=68, 43.3%), followed by the middle age group, 40 – 59 years (n=58, 36.9%). The highest frequency of spine surgeries was performed in the lumbar (n=43, 27.3%), lumbosacral (n=42, 26.8%) and cervical spines (n=42, 26.8%) almost in equal proportion. This was followed by thoracolumbar junction (n=13, 8.3%) and thoracic spine (n=8, 5.1%), while cervicothoracic junction, sacral and lumbosacropelvic accounted for 1.9% (n=3) each. Degenerative spine diseases (71.9%) accounted for the highest number of spine surgeries, followed by spinal trauma (19.7%) and spinal tumours (3.9%).

Conclusion: The study showed a male preponderance for spinal pathologies surgically managed in the hospital, and most of the pathologies were due to degenerative spine diseases. It also highlights the fact that spine pathologies are not rare in our environment, and more doctors should be encouraged to become spine surgeons to help in tackling these pathologies in our environment.