Articles

Patient Satisfaction with Outcome of Cervical Spine Surgery at the National Orthopaedic Hospital, Dala, Kano, Nigeria

/in /by

Background: Patient satisfaction is increasingly recognised as a crucial metric for evaluating surgical outcomes, complementing traditional clinical and radiological parameters. This study assesses patient satisfaction following cervical spine surgery at the National Orthopaedic Hospital (NOH), Dala, Kano, Nigeria, and identifies factors associated with satisfaction levels.

Methods: A cross-sectional study was conducted between January and December 2024 among 84 patients who underwent cervical spine surgery (anterior cervical discectomy and fusion, posterior decompression, or combined procedures) at NOH, Dala, with a minimum follow-up of six months. Data were collected using a structured questionnaire assessing demographic characteristics, clinical outcomes (pain using Visual Analogue Scale [VAS], functional status using modified Japanese Orthopaedic Association [mJOA] score), and satisfaction using a five-point Likert scale. Satisfaction was dichotomised as satisfied (very satisfied/satisfied) or dissatisfied (neutral/dissatisfied/very dissatisfied). Multivariate logistic regression identified independent predictors of satisfaction.

Results: The response rate was 82.4% (84/102). Mean age was 48.6 ± 12.4 years, with 62 males (73.8%) and 22 females (26.2%). Indications for surgery were degenerative conditions (52 patients, 61.9%) and trauma (32 patients, 38.1%). Overall satisfaction rate was 72.6% (61 patients). Mean VAS improved from 7.4 ± 1.6 preoperatively to 2.8 ± 1.2 postoperatively (p<0.001). Mean mJOA improved from 10.8 ± 2.4 to 14.2 ± 1.8 (p<0.001). Satisfied patients reported significantly greater improvement in VAS (mean change 5.2 ± 1.4 vs. 3.4 ± 1.2, p<0.001) and mJOA (mean change 4.2 ± 1.6 vs. 2.4 ± 1.4, p<0.001) compared to dissatisfied patients. Factors independently associated with satisfaction were: greater improvement in VAS (OR 3.84, 95% CI 1.92–7.68, p<0.001), higher postoperative mJOA (OR 2.96, 95% CI 1.48–5.92, p=0.002), and preoperative counselling adequacy (OR 2.54, 95% CI 1.28–5.04, p=0.008). Age, sex, indication, and surgical approach were not significant predictors.

Conclusion: Patient satisfaction following cervical spine surgery at NOH, Dala is high (72.6%) and comparable to international benchmarks. Pain relief, functional improvement, and preoperative counselling are the strongest determinants of satisfaction. These findings highlight the importance of managing patient expectations and optimising clinical outcomes to enhance satisfaction.

Comparison Between ACDF and Instrumented Posterior Decompression and Fusion in Cervical Spondylotic Myelopathy at the National Orthopaedic Hospital Dala, Kano, Nigeria: A Retrospective Comparative Study of 85 Patients

/in /by

Background: Cervical spondylotic myelopathy (CSM) is a leading cause of spinal cord dysfunction. Both anterior cervical discectomy and fusion (ACDF) and posterior decompression with instrumented fusion are established surgical approaches, but comparative data from Nigerian populations remain limited. This study compared clinical outcomes, perioperative parameters, and complications between ACDF and posterior instrumented fusion for CSM at the National Orthopaedic Hospital Dala (NOHD), Kano, Nigeria.

Methods: A retrospective comparative study reviewed records of 85 patients who underwent surgical decompression for CSM between January 2018 and December 2024. Patients were divided into two groups: ACDF (n=48) and posterior decompression with instrumented fusion (n=37). Data extracted included demographics, operative parameters, complications, and outcomes assessed by modified Japanese Orthopaedic Association (mJOA) score and Neck Disability Index (NDI) at baseline, 6 months, and 12 months post-surgery. Recovery rate was calculated using the Hirabayashi formula.

Results: The ACDF group had younger mean age (54.2 ± 9.8 vs. 62.6 ± 11.4 years; p=0.001) and fewer levels fused (1.8 ± 0.6 vs. 3.4 ± 0.8; p<0.001). ACDF was associated with shorter operative time (182 ± 46 vs. 236 ± 62 minutes; p<0.001), lower blood loss (210 ± 95 vs. 450 ± 240 mL; p<0.001), and shorter hospital stay (5.2 ± 2.4 vs. 8.4 ± 3.2 days; p<0.001). Both groups achieved significant mJOA improvement at 12 months: ACDF from 10.8 ± 2.4 to 14.2 ± 2.1 (p<0.001); posterior from 9.6 ± 2.6 to 13.1 ± 2.3 (p<0.001). Mean recovery rates were 56.8 ± 22.4% for ACDF and 48.6 ± 24.2% for posterior (p=0.12). NDI improved from 46.8 ± 14.2% to 24.6 ± 12.4% in ACDF and from 52.4 ± 15.6% to 29.8 ± 14.2% in posterior (p=0.08). Complication rates were 12.5% (ACDF) and 21.6% (posterior) (p=0.26). ACDF complications included dysphagia (6.3%) and graft-related (2.1%); posterior complications included C5 palsy (5.4%) and wound infection (8.1%).

Conclusion: Both ACDF and posterior instrumented fusion achieve significant neurological improvement in CSM patients at NOHD Kano. ACDF is associated with shorter operative time, less blood loss, and shorter hospital stay, while posterior approaches are preferred for multilevel disease and in older patients. Surgical approach should be individualized based on pathology, levels involved, and patient factors.