Predictors of Postoperative Discitis Following Surgery for Prolapsed Disc at the National Orthopaedic Hospital Dala Kano Nigeria

Abstract

Background: Postoperative discitis (POD) is a rare but serious complication following lumbar disc surgery, associated with prolonged hospitalisation, increased morbidity, and significant healthcare costs. This study aimed to identify predictors of POD and its impact on hospital stay following surgery for prolapsed intervertebral disc at a Nigerian tertiary hospital.

Methods: A retrospective cohort study of 197 patients who underwent surgery for prolapsed lumbar disc at the National Orthopaedic Hospital Dala, Kano, from January 2019 to December 2025 was conducted. Patients who developed POD (n=23) were compared with those who did not (n=174). Demographic, clinical, and surgical variables were analysed. Multivariate logistic regression identified independent predictors of POD.

Results: The incidence of POD was 11.7% (23/197). Among affected patients, 16 (69.6%) were male and 7 (30.4%) female. Additional hospitalisation due to POD ranged from 10 to 32 days (mean 18.6±6.4 days). Independent predictors of POD included: age ≥50 years (adjusted OR=4.2, 95% CI: 1.6–11.0), presence of diabetes mellitus (OR=3.8, 95% CI: 1.4–10.2), prolonged operative time >90 minutes (OR=2.9, 95% CI: 1.1–7.6), and modified laminectomy with microdiscectomy (compared with fenestration and microdiscectomy) (OR=3.1, 95% CI: 1.2–8.3). Patients with comorbidities had significantly longer hospital stays (p<0.05).

Conclusions: Postoperative discitis occurs in 11.7% of patients following lumbar disc surgery at our institution. Advanced age, diabetes mellitus, prolonged operative time, and more extensive surgical approaches are independent predictors. Early identification of high-risk patients and targeted preventive strategies are essential to reduce this complication and its associated burden.