• Justus Boever and Fassil Mesfin.
• Department of Neurosurgery, University of Missouri, Columbia, Missouri, USA. Electronic address: jcbf26@health.missouri.edu.
• World Neurosurg. 2021 Feb 1; 146: e1097-e1102.

BackgroundNeurosurgical practice in some African countries has significant differences in patient load and resource availability compared with North America. We designed a survey to determine reported differences in outcome of anterior cervical decompression and fusion surgery, including blood loss, length of stay, and follow-up time, among physicians on different continents. We expected outcomes in all categories to be pronounced between respondents in Africa compared with North America due to a multitude of factors.MethodsThe survey consisted of 7 questions and was sent to 352 neurosurgeons practicing on the continents of North America, Africa, or Other.ResultsA total of 62 surgeons responded, 44 from Africa, 15 from North America, and 3 from Other. A greater percentage of respondents in Africa reported an average follow-up time within 2 weeks compared with respondents practicing in North America (63.6% and 40%, respectively). On blood loss, 56% of surgeons in Africa reported >50 mL of intraoperative blood loss compared with 6.67% for respondents in North America. Over 90% reported length of stay of 2 or more days in Africa, compared with 6.67% in North America.ConclusionsOur findings demonstrate greater advances in reported surgical outcomes for patients in Africa than we expected, but still highlight key areas for improvement, almost certainly due to lack of resources.Copyright © 2020 Elsevier Inc. All rights reserved.

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