Initial experience with spinal stabilisation with pedicle screws and rods in Nigerians: indications and outcome of...

To provide an initial experience in performing the procedure of the use of pedicle screws and rods for stabilisation of the spinal column in Nigerians with highlights on indications and outcome of surgery.

The hospital records of all the patients who had the procedure were retrieved. Biodata, presentation, neuroimaging findings, surgical procedure and postoperative outcome were extracted from records. Evidence of recurrent spinal instability, change in neurological status, wound infection and implant related complications postoperatively were used as outcome measures.

Twenty seven procedures were performed in 26 patients [male: female was 1:1]. The age range was 26 to 77 years (mean=52.9, SD=13.7). Seventeen (65.4%) patients had degenerative spinal disease, while 9 (34.6%) had trauma. Five patients (19.2%) had thoracic spinal lesions and these were secondary to trauma, while there were 21 (80.8%) patients with lumbar spinal lesions. The indications for surgery were spinal instability in trauma cases and/or anticipated instability for degenerative cases. Two spinal segments were fused during 11 (40.7%) procedures, 3 in 10 (37.4%), 4 in 4 (14.8%) and 5 segments in 2 (7.4%) procedures. Post operatively, the Frankel grading improved in 6 (23.1%) patients, while it remained the same in 20 (76.9%). Back pain resolved in all but 1 (96.2%) patient. One (3.9%) patient each had screw fracture, recurrent instability and symptomatic redundant rod length while 2 (7.7%) peri-operative mortalities occurred due to cardiac events.

The most common indication for posterior spinal stabilisation with pedicle screws and rods in this study is established or anticipated instability from degenerative lumbar spinal disease.Immediate stabilisation was achieved in majority of the patients without postoperative neurological deterioration.