Background: The economic burden of spine surgery in Nigeria is poorly characterised, yet it is essential for resource allocation, patient counselling, and health policy. This study analysed the direct and indirect costs of surgical intervention for spine pathologies at a Nigerian tertiary centre and developed a predictive model for average treatment cost.

Methods: A retrospective cohort study of 595 patients who underwent spine surgery at the National Orthopaedic Hospital Dala, Kano, from January 2009 to June 2025 was conducted. Costs were analysed by urgency (emergency vs elective), anatomical region (cervical, thoracic, lumbosacral), pathology (trauma, degenerative, infection, deformity, tumour), and technique (instrumented vs non‑instrumented). A generalized linear model (GLM) with log link and gamma distribution was used to identify predictors of total cost. All costs are reported in Nigerian Naira (₦) with US dollar equivalents (US$1 = ₦1,500).

Results: The mean total cost per patient was ₦2,847,500 (US$1,898). Instrumented surgery was significantly more expensive than non‑instrumented surgery (₦3,562,400 vs ₦1,245,800, p<0.001). Costs varied by anatomy: cervical ₦3,124,600 (US$2,083), thoracic ₦2,986,400 (US$1,991), and lumbosacral ₦2,645,800 (US$1,764). By pathology, deformity was most expensive (₦4,125,600, US$2,750), followed by tumour (₦3,864,200, US$2,576), trauma (₦2,985,400, US$1,990), infection (₦2,654,800, US$1,770), and degenerative (₦2,415,600, US$1,610). The GLM identified instrumented technique (β=0.82, p<0.001), deformity pathology (β=0.68, p<0.001), and emergency surgery (β=0.34, p=0.002) as independent predictors of increased cost.

Conclusions: The cost of spine surgery in Nigeria is substantial, with instrumented procedures and deformity correction incurring the highest costs. The predictive model provides a practical tool for cost estimation and financial planning.