Clinical outcomes of posterior spinal stabilization with rigid vertical strut and spinal process wires (the Adeolu's technique) in a developing country.

INTRODUCTION

Conventional instrumentation for spinal stabilization is beyond the reach of many patients in developing countries. A low-cost and easily-available method of spinal stabilization using vertical struts and spinal process wires (Adeolu's technique) was recently introduced in Nigeria. We describe the clinical outcomes of a prospective series of patients managed using the technique.

METHODS

From 2011 to 2012, we performed posterior spinal stabilization in eighteen patients using the technique. Primary outcomes were radiological evidence of rigid stabilization and mobilization without restrictions referable to the procedure in the immediate post-operative period. Implant rotation, migration, back-out, fracture, wound infection, worsening neurological status and need for implant removal were secondary measures. Overall patient satisfaction was assessed using a five-point Likert scale. The average follow-up period was 11.6 months.

RESULTS

The average age of the patients was 45.8 years. Trauma with unstable spinal fractures (11), spondylosis (5), and thoracic extra-dural tumour (2) were the indications for surgery. The average number of spinal levels stabilized was 6. All patients had satisfactory primary outcomes. Implant rotation occurred in 3 patients (16.7%). There was no case of implant migration, back-out or fracture. Superficial surgical site infection occurred in one patient. There was no need to remove the implant in any subject and none had post-operative worsening of neurological status. The overall patient satisfaction was good with 17 patients (94.4%) reporting "highly satisfied" or "satisfied" with the surgical procedure.

CONCLUSION

The technique offers utility in a wide range of spinal pathologies and short-term clinical outcomes are good.