Publication:

Prediction of complications and death following cervical spine surgery at the National Orthopaedic Hospital, Dala, Kano, Nigeria

Background Cervical spine surgery is associated with significant morbidity and mortality, particularly in low-resource settings. Identifying predictors of adverse outcomes is essential for preoperative risk stratification and informed patient counselling.

Methods A retrospective cohort study was conducted on patients who underwent cervical spine surgery for traumatic and degenerative conditions between January 2018 and December 2024 at NOH, Dala Kano. Data extracted included demographics, clinical presentation, neurological status using Frankel grading, comorbidities, injury level, surgical details and postoperative outcomes. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of complications and mortality.

Results A total of 156 patients (124 males, 32 females) with a mean age of 44.8±14.2 years underwent cervical spine surgery. Major indication was trauma (71.8%). Overall complication rate was 31.4% and mortality rate was 9.6%. The commonest complication was respiratory tract infection (17.3%). The independent predictors of complications were: ASIA grade A injury (p 7 days (p=0.012). Independent predictors of mortality were: ASIA grade A injury (p 60 years (0.014) and presence of respiratory complications (p<0.001).

Conclusions ASIA A, high cervical level, associated chest trauma, delayed surgery and advanced age are significant predictors of adverse outcomes. These findings highlight the need for early referral, intensive perioperative respiratory support and targeted risk mitigation strategies in high-risk patients.