Computer-assisted brain surgery (neuronavigation) in Abuja, North Central Nigeria: A 3-year retrospective review and practical challenges

Introduction: Neuronavigation has become a standard of care in contemporary neurosurgery since more than two decades and is gradually being embraced in our local practice. It is, therefore, important to share our local experience, including practical challenges encountered with this technology. Aims and Objectives: The aim of this study is to review and present our early experience with stealth neuronavigation and to discuss the practical challenges encountered with the application of this technology in this environment. Methodology: Retrospective review of all consecutive cases over a 3-year period (January 2016-December 2018). Admitting diagnosis, operations, histological diagnosis, adjuvant treatments and 6 months outcome were the major study parameters. Procedural challenges were also highlighted. Data were analysed using simple descriptive statistics, and results were presented in tables and figures. Results: A total of 30 procedures were conducted. Nineteen males and 11 females (male: female = 1.7:1). Youngest was 8 months, oldest was 71 years, mean = 39 and standard deviation (SD) = 19.3. Operations performed were resection of mass lesion 18/30 (60%) and biopsy of mass lesion in 12/30 (40%) cases. Histological diagnostic yield was 100%. Mean duration of hospital stay was 2 days (SD = 0.25) for the biopsy group and 8 days (SD = 1.7) for the resection group. At 6 months review, 10/30 (33.3%) have died following progression and/or complications of their primary pathology. Conclusions: Wide spectrum of brain lesions were approached confidently with precision and minimal morbidity. No procedure-related mortality was recorded. Adjuvant treatments were easily deployed in line with a precise histological diagnosis. Practical challenges did not compromise the navigation process.