Clinical Outcomes and Magnitude of Improvement following Surgical Treatment of Lumbar Degenerative Spine Disease in Bauchi, Nigeria: A Mixed-Methods Study

Introduction: Traditionally, the success of spine surgery has been judged based on technical success. However, in particular, the trajectory of improvement from the patient’s perspective is an important outcome measure, especially in a resource-limited setting in Sub-Saharan Africa. The study aimed to evaluate the quantitative pre-and postoperative clinical outcomes, magnitude of physical functional improvement and qualitative lived experiences of patients with lumbar degenerative spine disease (LDSD) having open lumbar fusion surgery in Bauchi, Nigeria. Methodology: A convergent mixed-methods design was employed in which quantitative data collection using a Visual Analogue Scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), EuroQol 5-Dimension (EQ- 5D), and Short Form-36 (SF-36) took place prospectively pre-op and 1-month post-op from 53 patients undergoing open fusion. Subgroup differences in functional improvement were assessed using paired t-tests and one-way ANOVA models. At the same time, qualitative data were collected through 12 purposeful semi-structured interviews and thematic analysis. Results: The outcomes show highly significant statistical decreases in pain and disability in the total cohort and a huge improvement in health utilities. Individuals in this cohort, on average, experienced an improvement of 26.7% on the ODI and a meaningful reduction in pain on VAS tools. The one-way ANOVA models revealed that a shorter duration of preoperative symptoms (<12 months) was the only strongest single predictor of a greater magnitude of clinical improvement and greater overall satisfaction ( p < 0.001 ). The qualitative findings situate these measurements within a thematic context, which includes early structural decompression relief, prolonged baseline muscle wasting limiting effect, and out-of-pocket implant expenditure strain. Conclusion: Open lumbar fusion offers substantial and statistically robust short-term enhancements in clinical parameters within the Nigerian healthcare context. Optimising the total degree of clinical improvement requires active clinical endeavour in early screening, reducing patient presentation delays and arranging clear pre-surgical counselling with regard to physical and financial recovery parameters.