Outcome of Long Construct Spine Surgery at the National Orthopaedic Hospital Dala Kano Nigeria

Background: Long construct spine surgery (T10 to S1 or S2AI) is a major intervention for complex spinal disorders, yet functional outcomes in resource-limited settings are poorly characterised. This study aimed to determine functional outcomes and identify predictors of favourable outcomes following long construct spine surgery at a Nigerian tertiary hospital.   Methods: A retrospective cohort study of 117 patients who underwent long construct spine surgery (T10–S1 or S2AI) at the National Orthopaedic Hospital Dala, Kano, from January 2019 to December 2025 was conducted. Functional outcomes assessed at minimum 12-month follow-up included: ability to walk 100 metres comfortably, ability to stand for 10 minutes without discomfort, ability to return to previous job or migrate to a new job, and ability to fulfil sexual obligations. Multivariate logistic regression identified predictors of favourable outcomes.   Results: The mean age was 54.6±12.8 years; 68 patients (58.1%) were male. At final follow-up, 78 patients (66.7%) could walk 100 metres comfortably, 82 (70.1%) could stand for 10 minutes, 41 (35.0%) had returned to work or migrated to new employment, and 52 (44.4%) reported ability to fulfil sexual obligations. Independent predictors of favourable outcomes included: age <60 years (adjusted OR 2.8, 95% CI: 1.4–5.6), absence of postoperative complications (OR 3.2, 95% CI: 1.5–6.8), and sagittal balance restoration (PI-LL mismatch ≤10°) (OR 2.5, 95% CI: 1.2–5.2).   Conclusions: Long construct spine surgery in this Nigerian cohort achieves favourable mobility outcomes in approximately two-thirds of patients, but return to work and sexual function remain limited. Younger age, absence of complications, and restoration of sagittal balance are key predictors of success.