Pattern and outcomes of neurosurgical interventions in Ado-Ekiti, Nigeria: a retrospective study

Oluwamuyiwa Adeniyi Dada

doi:10.18203/2320-6012.ijrms20261671

Authors

Oluwamuyiwa Adeniyi Dada Department of Surgery, Faculty of Clinical Sciences, College of Medicine, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria

DOI:

https://doi.org/10.18203/2320-6012.ijrms20261671

Keywords:

Surgical outcomes traumatic brain injury, Spine surgery, Neurosurgical interventions, Craniotomy, Laminectomy

Abstract

Background: Neurosurgical practice in resource-limited settings is often shaped by a high burden of trauma and delayed presentation. This study evaluated the indications, procedures, and outcomes of neurosurgical interventions in Ado-Ekiti, Nigeria.

Methods: This was a retrospective hospital-based study which covered an 18-month period from July 2024 to December 2025. A total of 86 patients who underwent neurosurgical procedures were included. Data on socio-demographic characteristics, clinical indications, types of procedures, postoperative complications, and outcomes were analyzed.

Results: Most patients were males (67.4%), with the highest proportion aged 18-40 years (39.5%). Over half presented through the emergency unit (53.5%). Traumatic brain injury was the most common indication for surgery (34.9%), followed by spinal cord compression (16.3%) and intracranial tumors (14.0%). The most frequently performed procedures were burr hole drainage (23.3%) and laminectomy (23.3%), followed by craniotomy (20.9%). Postoperative complications were observed in 39.5% of patients, with surgical site infection (10.5%) and seizures (8.1%) being the most common. At discharge, 62.8% of patients improved, while mortality was 14.0%. Good recovery on the Glasgow Outcome Scale was recorded in 46.5% of cases. No statistically significant association was found between procedure type and mortality outcome (χ²=1.79, p=0.878).

Conclusions: Neurosurgical interventions in Ado-Ekiti are predominantly driven by trauma-related conditions, with generally favorable outcomes. Improving early presentation and perioperative care may further enhance patient outcomes.

References

Dewan MC, Rattani A, Fieggen G, Arraez MA, Servadei F, Boop FA, et al. Global neurosurgery: the current capacity and deficit in the provision of essential neurosurgical care. Executive Summary of the global neurosurgery initiative at the global surgery and social change. J Neurosurg. 2018;130(4):1-10.

Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N, Ameh EA, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Int J Obstet Anesth. 2015;386(9993):569-624.

Alkire BC, Raykar NP, Shrime MG, Weiser TG, Bickler SW, Rose JA, et al. Global access to surgical care: a modelling study. Lancet Glob Health. 2015;3(6):e316-23.

Hyder AA, Wunderlich CA, Puvanachandra P, Gururaj G, Kobusingye OC. The impact of traumatic brain injuries: a global perspective. NeuroRehabilitation. 2007;22(5):341-53.

Adeloye D. An estimate of the incidence and prevalence of stroke in Africa: a systematic review and meta-analysis. PLoS ONE. 2014;9(6):e100724.

Roozenbeek B, Maas AIR, Menon DK. Changing patterns in the epidemiology of traumatic brain injury. Nat Rev Neurol. 2013;9(4):231-6.

Ogunleye OO, Alfin JD, Ogunleye OB, Jauro AA. Challenges and prospects of neurosurgical services in Bauchi, north-east Nigeria. Int Surg J. 2023;10(2):195-9.

Park KB, Johnson WD, Dempsey RJ. Global neurosurgery: the unmet need. World Neurosurg. 2016;88:32-5.

Mezue WC, Ndubuisi CA, Chikani MC, Achebe DS, Ohaegbulam SC. Traumatic extra hematoma in Enugu, Nigeria. Niger J Surg. 2012;18(2):80.

Obande J, Otorkpa E, Obande E. Outcome of management of neurosurgical patients in the intensive care unit: An early clinical audit of a single institution from a developing country. Ann Clin Biomed Res. 2021;2(1):89.

Rabiu TB, Komolafe EB. Spectrum of Neurosurgical Operations at the UNIOSUN Teaching Hospital, Osogbo, Nigeria. West Niger J Med Sci. 2022;5(2):55-62.

Emejulu JK, Malomo AO. Epidemiological patterns of head injury in a newly established neurosurgical centre services; one-year prospective study. Afr J Med Med Sci. 2018:37(4):383-8.

Ishaku CM, Jawa BK, Maduagwu SM, Hassan AB, Lawan A, Rufa'i AA, et al. Pattern and outcome of traumatic spinal cord injury managed at University of Maiduguri Teaching Hospital, Nigeria: A retrospective study. Niger Postgrad Medi J. 2021;28(2):139-44.

Peden MM. World report on road traffic injury prevention. World Health Organization; 2004 Mar 23.

Emejulu JK, Eze BU, Okoye OA, Ekweogwu OC. The burden of neurosurgical emergencies in a tertiary hospital and the need to attract more trainees into Neurosurgery. OJM. 2011:23(1-4):24-9.

Idowu OE, Apemiye RA. Outcome of myelomeningocoele repair in sub-Saharan Africa: the Nigerian experience. Acta Neurochirurg. 2008;150(9):911-3.

Korinek AM, Golmard JL, Elcheick A, Bismuth R, Van Effenterre R, Coriat P, et al. Risk factors for neurosurgical site infections after craniotomy: a critical reappraisal of antibiotic prophylaxis on 4578 patients. Brit J Neurosurg. 2005;19(2):155-62.

Patir R, Mahapatra AK, Banerji AK. Risk factors in postoperative neurosurgical infection: A prospective sturdy. Acta Neurochir (Wien). 1992;119(1-4):80-4.

Hutchinson PJ, Kolias AG, Timofeev IS, Corteen EA, Czosnyka M, Timothy J, et al. Trial of decompressive craniectomy for traumatic intracranial hypertension. N Engl J Med. 2016;375(12):1119-30.

Choksey MS, Malik IA. Zero tolerance to shunt infection: can it be achieved? J Neurol Neurosurg Psychiatry. 2004;75(1):87-91.