Early results of two methods of posterior spinal stabilization in Nigerians.

Background: In this study, early outcomes of the spinous process wiring with vertical strut (SPWVS) were compared with that of standard pedicle screw and rod (PSR) in our patients.

Materials And Methods: We obtained patients' bio-data, diagnosis, investigations, cost of implant, operative circumstances, complications, and outcomes from clinical documentation. Outcome measures, including postoperative infection and persistent/recurrent instabilities, implant related problems, operative blood loss and time and cost, were compared in the two groups of patients.

Results: Forty one (M:F-0.9:1) patients had PSR and 35 (M:F-2.2:1) had SPWVS. There was no difference in the occurrence of post-operative instability ( P = 0.630), surgical site infection ( P ≥ 0.416), neurological deficits ( P ≥ 0.461) and implant related complications ( P ≥ 0.461) in the two groups of patients. Cost of implant in the PSR group range from N138,000 (for 2 level fusion) (1USD = N159) to N246,000 (for 4 level fusion) with an average of N192,000 (Standard deviation [SD] N44,090.81) depending on the number of level fused while the cost of implant for SPWVS was N8,000 irrespective of the number of level of fusion being carried out ( P = 0.000). Mean estimated blood loss intra-operatively was higher for PSR (761.33 [SD 396.24] ml) than SPWVS (524.58 [SD 504.70] ml) ( P = 0.005). Mean operation time was 397.17 (SD 122.183) min and 249.44 (SD 130.31) min PSR and SPWVS ( P = 0.000).

Conclusion: SPWVS appears to be a good alternative to PSR, especially in our resource limited environment, in view of similar post-operative infection rate, implant complication, stability and post-operative neurological deterioration as well as shorter operation time, less estimated blood loss and much cheaper cost of implant in the former.