A Comparison of Reported Outcomes of Anterior Cervical Spinal Surgery Among Neurosurgeons in Africa and North America

Background: Neurosurgical practice in some African countries has significant differences in patient load and resource availability compared with North America. We designed a survey to determine reported differences in outcome of anterior cervical decompression and fusion surgery, including blood loss, length of stay, and follow-up time, among physicians on different continents. We expected outcomes in all categories to be pronounced between respondents in Africa compared with North America due to a multitude of factors. Methods: The survey consisted of 7 questions and was sent to 352 neurosurgeons practicing on the continents of North America, Africa, or Other. Results: A total of 62 surgeons responded, 44 from Africa, 15 from North America, and 3 from Other. A greater percentage of respondents in Africa reported an average follow-up time within 2 weeks compared with respondents practicing in North America (63.6% and 40%, respectively). On blood loss, 56% of surgeons in Africa reported >50 mL of intraoperative blood loss compared with 6.67% for respondents in North America. Over 90% reported length of stay of 2 or more days in Africa, compared with 6.67% in North America. Conclusions: Our findings demonstrate greater advances in reported surgical outcomes for patients in Africa than we expected, but still highlight key areas for improvement, almost certainly due to lack of resources.