Research & training

The FOCOS Research Unit collects, analyses and interprets clinical data to add to what is known about orthopaedic and spine surgery, and to guide clinical decisions.

What the research team does

• Designs studies and builds data collection tools
• Collects, manages and analyses data
• Writes scientific reports and publishes
• Keeps the hospital’s research database up to date
• Follows every patient in halo-gravity traction before surgery, with photos and videos used for teaching and to evaluate surgery
• Supports the medical team in clinics

Our studies

We run observational and experimental studies, looking back at past cases and following patients forward. Our main themes are spine deformity, degenerative spine disease and joint replacement. An interdisciplinary group of surgeons, physicians, anaesthetists, nurses, dietitians, radiologists, biomedical scientists and physiotherapists agrees each study’s goals and methods, in line with ethical guidelines.

Research ethics

Every study is reviewed by the Institutional Review Board of the Noguchi Memorial Institute for Medical Research, University of Ghana. All participants give consent; for children under 18, we ask for the child’s agreement and a parent’s consent.

International collaboration

We work with international spine research teams, including the Growing Spine Study Group and the FOX Pediatric Deformity Study Group, and with individual investigators.

Mission trips

Each year, with our international partners, our surgeons and researchers travel to countries in East and West Africa to:

• check on patients after surgery: their wellbeing, any complications and their quality of life
• follow up patients who cannot afford to fly back to Ghana
• assess new patients and prioritise them by age, symptoms and urgency
• collect quality-of-life questionnaires
• keep patients in long-term studies from being lost to follow-up
• carry out minor procedures, such as lengthening growing rods

Academic programmes

FOCOS welcomes trainees and visiting clinicians:

• Academic visitors: visiting observers, visiting clinicians and the FOCOS Distinguished Educator
• Graduate medical education: residents of the Ghana College of Physicians and Surgeons and the West African College of Surgeons, and FOCOS spine fellows
• Research trainees: research fellows and clinical preceptorships
• Nursing and allied health professionals
• Medical student internships

Visitors from outside Ghana must tell the academic office at least two months before they arrive, so that a temporary working licence can be arranged if needed. To apply, email info@focosgh.com.

Publications

Recent research by FOCOS surgeons, physicians and researchers:

• Halo Gravity Traction Can Mitigate Preoperative Risk Factors and Early Surgical Complications in Complex Spine Deformity
• The Use of Halo Gravity Traction in the Treatment of Severe Early Onset Spinal Deformity
• New neurologic deficit and recovery rates in the treatment of complex pediatric spine deformities exceeding 100 degrees or treated by vertebral column resection (VCR)
• One-stage multiple posterior column osteotomies and fusion and pre-op halo-gravity traction may result in a comparative and safer correction of complex spine deformity than vertebral column resection
• Characterization of complex vertebral transposition (gamma deformity) > 180 degrees: clinical and radiographic outcomes of halo gravity traction and vertebral column resection (VCR)
• The Effect of Prolonged Pre-Operative Halo Gravity Traction for Severe Spinal Deformities on the Cervical Spine Radiographs
• Surgical outcomes of severe spinal deformities exceeding 100° or treated by vertebral column resection (VCR). Does implant density matter?: an observational study of deformity groupings
• Surgical management of complex post-tuberculous kyphosis among African patients: clinical and radiographic outcomes for a consecutive series treated at a single institution in West Africa
• Postoperative Pulmonary Complications in Complex Pediatric and Adult Spine Deformity: A Retrospective Review of Consecutive Patients Treated at a Single Site in West Africa
• Apex of deformity for three-column osteotomy. Does it matter in the occurrence of complications
• Characterization of Significant Neurophysiologic Intraoperative Monitoring Events in Severe Spinal Deformity Surgery
• Preoperative Halo Gravity Traction, Posterior Column Osteotomies and Rib Resections: Are Three-Column Osteotomies Always Needed for Severe Rigid Deformities: A Prospective Analysis
• Preoperative Halo-Gravity Traction for Severe Spinal Deformities at an SRS-GOP Site in West Africa: Protocols, Complications and Results
• Surgical risk stratification based on preoperative risk factors in adult spinal deformity
• The Use of Arm Span as a Substitute for Height in Calculating Body Mass Index (BMI) for Spine Deformity Patients
• A novel radiographic classification of severe spinal curvatures exceeding 100°: the Omega (Ω), gamma (γ) and alpha (α) deformities
• Neuroschistosomiasis: A Case Report and Review of Literature
• Intraoperative neurophysiology monitoring in posterior spinal fusion: insight from a Ghanaian patient with Brown-Séquard Syndrome
• The Evolution of Intraoperative Neuromonitoring in Ghana and West Africa
• Clinical and Radiographic Outcomes Following Complex Spine Reconstruction in Neurofibromatosis with Severe Spinal Deformity
• Yield of epileptiform abnormalities and predictors on routine electroencephalography in a neurology facility in Ghana. BMC Neurol (2026).