Surgical Disorders of the Spine in Adults: Aetiology and Outcome

Background: There has been steady and progressive advancement in spine surgery in Nigeria with the increase in spine surgeons, availability of magnetic resonance imaging (MRI), intraoperative fluoroscopy and some spinal titanium implants. We decided to study the frequency of various spine pathologies requiring surgery in our centre and the outcome of surgical intervention so as to document the prevailing surgical spinaldisorders in our practice and know the commonly associated complications.Methods: A retrospective study over a 27month period (August 2006-October 2008) was carried out. All the patients were consecutive adult patients aged 18years and above, seen during the study period. Data collected included the patients' demographics, radiological findings, indication for surgery, surgical procedure, blood loss during surgery, blood transfusions, and postoperative complications related to the operation. Pre-operative and postoperative power grade (most predominant power in the affected limbs) were also noted and recorded for all patients. The data was recorded in procedural forms, stored electronically and subsequently analysed using SPSS version 13.Results: There were 27 patients (19 males and 8 females). Their ages ranged between 18 and 72years with a median age of 40 years. The most common indications for surgery were degenerative spine disease (48.1%) and spinal trauma (44.4%). Twenty-five patients (92.6%) presented with significant motor deficit (power grade 4 following surgical intervention. Iatrogenic dural tear occurred in one patient. All the surgeries except one were posterior spinal canal decompressions (22 standard laminectomies and 4 hemilaminectomies) with facetectomy in four patients and implantuse in 3 patients. There was no post-operative neurologic deterioration or significant post-operative complication.Conclusion: Degenerative spine disease and spinal trauma are the two most common indications for surgical spinal intervention in our centre, and surgical intervention has been found to improve neurological status. The indication for surgery in these two conditions should always be kept in mind to ensure early referral and appropriate treatment so as to optimize patient's outcome