Resident Physician University of Florida Gainesville, FL, US
Introduction: Spine injury represents a significant burden of disease globally and can affect the quality of lives of both patients and families as well as posing a significant economic burden on healthcare systems. Understanding the causes of spine pathology, current practice patterns, and outcomes is an important first step in identifying systemic gaps and informing healthcare practitioners and public policy makers working to improve public health and surgical services. The purpose of this study was to establish the burden of spine pathology and outcomes in Sierra Leone in the absence of a trained spine surgeon.
Methods: A retrospective chart review was conducted of all patients who presented to Connaught Hospital in Freetown, Sierra Leone from 2019-2023. All patients with neurologic and neurosurgical conditions were included in the database and those with traumatic and degenerative spine disease were included in this study.
Results: 2,992 patients with neurosurgical conditions were identified, of which 634 (21.2%) presented with spine pathology. A majority of patients with traumatic spine injury were male (74.1%) while females more frequently presented with degenerative spine conditions (56.5%). The most common reasons for presentation were back pain, road traffic accident, and fall from height. Only 19.7% of patients had diagnoses confirmed with some form of imaging. Overall mortality was 3%. Approximately half (46.8%) of patients presented for clinic follow up.
Conclusion : The neurosurgical burden of spine disease in Sierra Leone is substantial, with many people’s quality of life being substantially affected by lack of spine care. The findings of this study will contribute to the existing body of knowledge on global spine pathology and will be useful in informing the ongoing efforts to mitigate the burden of injury, improve surgical delivery services in Sierra Leone, and improve the well-being of patients with these debilitating conditions.
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