Surgical Outcomes of Spinal Trauma Management in a Resource-Limited Country

Introduction: Spinal Cord Injuries (SCIs) constitute a major cause of long-term disability in low-resource settings. In these contexts, surgical management remains particularly challenging due to delayed presentation, limited technical resources, and organizational constraints. Objective: To evaluate the surgical management and outcomes of spinal cord injuries in a low-resource country. Methods: We conducted a retrospective descriptive and analytical study, from January 1, 2019, to December 31, 2023. All patients admitted for spinal trauma were included. Epidemiological, clinical, radiological, therapeutic, and outcome variables were analyzed. Data management and statistical analyses were performed using Epi Data version 3.1 (2007) and Microsoft Excel 2021. Results: A total of 67 patients underwent surgical intervention. The mean age was 40.9 ± 14.3 years, with a marked male predominance. Road traffic accidents were the leading etiology, accounting for 65.9% of cases. Cervical spine injuries were the most frequent (67.1%), and 37.8% of patients presented with complete neurological impairment (ASIA grade A). The mean time to surgical intervention was 49 days. Postoperative neurological improvement was observed in 26.9% of patients, while the overall mortality rate was 4.5%. Multivariate analysis demonstrated a significant association between ASIA grade A and the occurrence of postoperative complications (odds ratio ≈ 8.7; p = 0.008). Conclusion: Despite prolonged surgical delays, surgery provides acceptable outcomes in terms of spinal stabilization. Improving the organization of the emergency care pathway for spinal trauma should be considered a critical priority to improve neurological and functional outcomes in low-resource settings.