Reoperation rate in patients undergoing spine surgery at the National Orthopaedic Hospital Dala Nigeria

Background: Spine surgery is increasingly performed in Nigeria to address a variety of degenerative, traumatic, and deformity conditions. While initial surgical outcomes are frequently reported, the rate and reasons for subsequent reoperation remain poorly characterized in the local population. Reoperation is a critical metric of surgical efficacy, patient safety, and healthcare resource utilization. Objective: To determine the cumulative reoperation rate, identify the common causes for revision surgery, and analyze associated risk factors in patients who underwent spine surgery at a tertiary center in Nigeria. Methods: This was a retrospective cohort study of patients who underwent spine surgery at National Orthopaedic Hospital Dala Kano Nigeria; between January 2018 and December 2022. Patients with a minimum follow-up of 24 months were included. Data extracted from medical records included patient demographics, primary diagnosis, surgical procedure (e.g., decompression, fusion, instrumentation), and level of surgery. The primary outcome was the need for a subsequent reoperation at the same or adjacent level. Survival analysis was used to calculate the cumulative reoperation rate, and Cox regression analysis was employed to identify independent risk factors for reoperation. Results: A total of patients met the inclusion criteria. The mean age was 52.4? 14.6 years, with a male-to-female ratio of 1.3:1. The most common primary diagnoses were trauma (45%) and degenerative spine disease (30%). The overall cumulative reoperation rate was 8.5% at 2 years and 12.1% at 5 years. The most frequent indications for reoperation were surgical site infection (30%), adjacent segment disease (25%), and implant failure (20%). On multivariate analysis, diabetes mellitus and multi-level fusion were significantly associated with an increased risk of reoperation (p < 0.05). Conclusion: The reoperation rate following spine surgery in this Nigerian cohort is comparable to reported rates in other settings, though infection remains a disproportionately common cause. These findings underscore the need for enhanced perioperative protocols to reduce infection and careful patient selection to mitigate other modifiable risk factors. Larger, multi-center studies are warranted to develop national benchmarks and improve long-term surgical outcomes.