Articles

A Comparative Review of Spine Surgeries in Two New Neurosurgery Centres in an Urban and Rural Environment in Southeast Nigeria

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Background: The Imo State University Teaching Hospital (IMSUTH) located in a rural setting commenced neurosurgical services in January 2016 with a spine procedure as the first case whereas the Imo State Specialist Hospital (IMSSH) located in an urban setting commenced neurosurgical services in April 2021 and spine procedures in August 2021. The presentation of surgically managed spine pathologies in both hospitals were compared.

Aims: The study aimed to descriptively compare the number of spine procedures performed in both hospitals including the age and gender distribution of the surgically managed spine patients, the spine pathologies and their distribution.

Methods: The surgical records of all spine patients who had surgical procedures at IMSUTH, Orlu, from January 2016 to May 2020 (42 months), and at IMSSH, Owerri, from August 2021 to July 2024 (36 months) were retrospectively reviewed.

Results: During the study periods, in IMSUTH, Orlu, there were 27 spine surgeries, giving an average of 1 spine procedure in 2 months whereas in IMSSH, Owerri, there were 157 spine surgeries giving an average of 4 spine surgeries per month. Interestingly the distribution of spine procedures revealed that the highest frequency of spine surgeries was performed in the lumbar spine (n=7, 26% in IMSUTH; n=43, 27.3% in IMSSH) followed by lumbosacral spine (n=6, 22.2% in IMSUTH; n=42, 26.8% in IMSSH) in both hospitals. And quite interesting also is that trauma (n=15, 55.6%) accounted for the highest number of spine surgeries in the rural environment of IMSUTH, Orlu, while degenerative spine diseases (n=113, 71.9%) accounted for the highest number of spine surgeries in the urban environment of IMSSH, Owerri.

Conclusion: The study revealed that spine pathologies are not uncommon in resource poor settings especially in the urban environment. There is a male preponderance for spine surgeries. Lumbar/lumbosacral spine pathologies are common in our resource poor settings but trauma related spine pathologies are more common factors for spine surgeries in rural settings.  There is need to improve access to spine care in the rural environments.

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

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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.