Publication:

Predictive factors of postoperative outcome after cervical spine surgery at the Soavinandriana Hospital Center, Madagascar: a retrospective analytical study

Background Cervical spinal disorders represent a major cause of neurological morbidity. The aim of this study was to identify predictive factors of postoperative outcome after cervical spine surgery at the Soavinandriana Hospital Center.

Methods We conducted a retrospective analytical study in the Neurosurgery Department of CENHOSOA from January 1st, 2020 to December 31st, 2023. Patients operated on for cervical spine disorders during this period were included. Epidemiological, clinical, paraclinical, operative, and outcome parameters were analyzed. A comparative analysis according to the surgical approach was performed.

Results Fifty-seven patients were included among 864 hospitalized patients. The mean age was 48 years (±14.93), with a balanced sex distribution. The anterior approach accounted for 78.94% (n=45) of surgical procedures. The main surgical indications were cervical myelopathy in 40.35% (n=23) and traumatic cervical lesions in 31.57% (n=18). Postoperative clinical improvement was observed in 78.94% (n=45) of cases. Postoperative complications and infections were significantly more frequent after posterior approach surgery (p=0.026). The anterior approach was associated with a shorter hospital stay (OR=19.9; p=0.027). Cervical fractures and dislocations were independent factors associated with intensive care unit admission.

Conclusions Cervical spine surgery provides satisfactory clinical improvement with low postoperative mortality. The anterior approach was associated with shorter hospital stay and fewer postoperative infectious complications.