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

Autor: Malomo TA; Department of Neuroscience, University of British Columbia, Vancouver, British Columbia, Canada., Nischal SA; Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA; School of Clinical Medicine, University of Cambridge, Cambridge, UK., Trillo-Ordonez Y; Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA., Oyemolade TA; Department of Surgery, Federal Medical Centre, Owo, Nigeria., Nwaribe EE; Department of Surgery, National Hospital, Abuja, Nigeria., Okere OE; Department of Neurosurgery, University College Hospital, Ibadan, Nigeria., Deng DD; Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA., Abu-Bonsrah N; Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland, USA., Oboh EC; Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA., Asemota I; Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA., Still MEH; Department of Neurosurgery, University of Florida, Gainesville, Florida, USA., Waguia-Kouam R; Campbell School of Osteopathic Medicine, Lillington, North Carolina, USA., Seas A; Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA; Pratt School of Engineering, Duke University, Durham, North Carolina, USA; School of Medicine, Duke University, Durham, North Carolina, USA., Oboh EN; College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA., Ogundeji OD; Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA., Rahman R; Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA., Reddy P; College of Medicine, University of Florida, Gainesville, Florida, USA., Ugorji C; Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA., Badejo OA; Department of Neurosurgery, University College Hospital, Ibadan, Nigeria., von Isenburg M; Medical Center Library and Archives, Duke University, Durham, North Carolina, USA., Haglund MM; Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Health System, Durham, North Carolina, USA; Global Health Institute, Duke University, Durham, North Carolina, USA., Fuller AT; Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Health System, Durham, North Carolina, USA; Global Health Institute, Duke University, Durham, North Carolina, USA., Adeleye AO; Department of Neurosurgery, University College Hospital, Ibadan, Nigeria., Ukachukwu AK; Division of Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Health System, Durham, North Carolina, USA. Electronic address: alvan.ukachukwu@duke.edu.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2024 May; Vol. 185, pp. e209-e242.
DOI: 10.1016/j.wneu.2023.12.138
Abstrakt: Objective: Spinal 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.
Methods: Four 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 χ 2 independence tests (α = 0.05).
Results: One 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.
Conclusions: This 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.)
Databáze: MEDLINE
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