Articles

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

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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.

A Comprehensive Study on Integration of Big Data and AI in Financial Industry and its Effect on Present and Future Opportunities

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This study evaluates the substantial influence of AI-technologies in the finance industry, with advancement expected to accelerate in the next few years. It also forecasts the expansion of AI adoption across various business sectors and the integration of AI-based operational networks with existing commercial systems to meet consumer demands. The financial industry will blend AI-based transaction channels with established systems, enhancing the customer experience and efficiency. This integration will streamline and advance transaction processes, making them more responsive to customer demands. The standard change in customer dealings is expected to be a significant transformation in the financial sector. The transformative potential of Big Data and AI in the financial sector goes beyond operational improvements; these technologies will create new opportunities for growth and development, giving financial institutions a modest point in operational efficiency and innovative product and service offerings.
This study aims to investigate the overall impact of the convergence of Big Data and AI on the financial industry. It anticipates increased revolution, diversification of commercial applications, and smooth AI integration into existing systems. These technologies will shape the financial environment in the future, offering new opportunities for industry participants and consumers.