• World Neurosurg · May 2024

    The Epidemiology of Spinal Neurosurgery in Nigeria: A Systematic Review and Patient-Level Analysis.

    • Toluyemi A Malomo, Shiva A Nischal, Yesel Trillo-Ordonez, Toyin A Oyemolade, Evaristus E Nwaribe, Oghenekevwe E Okere, Di D Deng, Nancy Abu-Bonsrah, Ena C Oboh, Isaac Asemota, Megan E H Still, Romaric Waguia-Kouam, Andreas Seas, Ehita N Oboh, Olaniyi D Ogundeji, Raphia Rahman, Padmavathi Reddy, Chiazam Ugorji, Oluwakemi A Badejo, Megan von Isenburg, Michael M Haglund, Anthony T Fuller, Amos O Adeleye, and Alvan-Emeka K Ukachukwu.
    • Department of Neuroscience, University of British Columbia, Vancouver, British Columbia, Canada.
    • World Neurosurg. 2024 May 1; 185: e209e242e209-e242.

    ObjectiveSpinal pathologies are prevalent in Nigeria, though epidemiological data remains sparse. This systematic review used pooled patient-level data from across the country to generate a standardized epidemiological reference.MethodsFour research databases and gray literature sources were searched. Risk of bias assessment was conducted using Risk of Bias in Non-Randomised Studies - of Interventions and Cochrane's risk of bias tool. We descriptively analyzed all article metrics and statistically analyzed relevant data variables via paired t-test and χ2 independence tests (α = 0.05).ResultsOne hundred twenty-seven articles, comprising a patient cohort of 8425 patients, were analyzed. Most were retrospective cohort studies (46.5%) and case reports/series (31.5%), with an overall moderate-high risk of bias. Most studies were published in the last 20 years. Most patients were male (∼2.5 males per female), with an average age of 43.2 years (±16.4). Clinical diagnoses spanned the breadth of spinal neurosurgery. Approximately 45.0% of patients had complete spinal impairment. Pain (41.7%) was the most reported presenting feature. X-ray (45.1%) was the most common investigation used. Intervertebral disc herniation (18.9%) was the most prevalent imaging finding on MRI. Most patients were managed nonoperatively (57.8%), with a favorable outcome in 27.4% of patients. Posttreatment complications included pressure sores, infection, and motor deficits.ConclusionsThis systematic review and pooled analysis provide an epidemiological overview of spinal neurosurgery in Nigeria over the last 60 years and serves as a useful reference to direct future global research in this arena.Copyright © 2023 Elsevier Inc. All rights reserved.

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