Patient Satisfaction with Outcome of Cervical Spine Surgery at the National Orthopaedic Hospital, Dala, Kano, Nigeria

Abstract : Background: Patient satisfaction is increasingly recognised as a crucial metric for evaluating surgical outcomes, complementing traditional clinical and radiological parameters. This study assesses patient satisfaction following cervical spine surgery at the National Orthopaedic Hospital (NOH), Dala, Kano, Nigeria, and identifies factors associated with satisfaction levels. Methods: A cross-sectional study was conducted between January and December 2024 among 84 patients who underwent cervical spine surgery (anterior cervical discectomy and fusion, posterior decompression, or combined procedures) at NOH, Dala, with a minimum follow-up of six months. Data were collected using a structured questionnaire assessing demographic characteristics, clinical outcomes (pain using Visual Analogue Scale [VAS], functional status using modified Japanese Orthopaedic Association [mJOA] score), and satisfaction using a five-point Likert scale. Satisfaction was dichotomised as satisfied (very satisfied/satisfied) or dissatisfied (neutral/dissatisfied/very dissatisfied). Multivariate logistic regression identified independent predictors of satisfaction. Results: The response rate was 82.4% (84/102). Mean age was 48.6 ± 12.4 years, with 62 males (73.8%) and 22 females (26.2%). Indications for surgery were degenerative conditions (52 patients, 61.9%) and trauma (32 patients, 38.1%). Overall satisfaction rate was 72.6% (61 patients). Mean VAS improved from 7.4 ± 1.6 preoperatively to 2.8 ± 1.2 postoperatively (p<0.001). Mean mJOA improved from 10.8 ± 2.4 to 14.2 ± 1.8 (p<0.001). Satisfied patients reported significantly greater improvement in VAS (mean change 5.2 ± 1.4 vs. 3.4 ± 1.2, p<0.001) and mJOA (mean change 4.2 ± 1.6 vs. 2.4 ± 1.4, p<0.001) compared to dissatisfied patients. Factors independently associated with satisfaction were: greater improvement in VAS (OR 3.84, 95% CI 1.92–7.68, p<0.001), higher postoperative mJOA (OR 2.96, 95% CI 1.48–5.92, p=0.002), and preoperative counselling adequacy (OR 2.54, 95% CI 1.28–5.04, p=0.008). Age, sex, indication, and surgical approach were not significant predictors. Conclusion: Patient satisfaction following cervical spine surgery at NOH, Dala is high (72.6%) and comparable to international benchmarks. Pain relief, functional improvement, and preoperative counselling are the strongest determinants of satisfaction. These findings highlight the importance of managing patient expectations and optimising clinical outcomes to enhance satisfaction.