Published date: Dec 06 2024

Journal Title: Journal of Spine Practice

Issue title: Journal of Spine Practice (JSP): Volume 4, Issue 1

Pages: 1 - 12

DOI: 10.18502/jsp.v4i1.17060

Munosiya Mulemwamunosiyamulemwa@gmail.comDepartment of Physiotherapy, School of Health Sciences, University of Zambia, Lusaka

Joseph Lupengalupengajoseph@gmail.comDepartment of Epidemiology and Biostatistics, School of Public Health, University of Zambia, Lusaka

Martha Banda-Chalwemafumartha94@gmail.comDepartment of Physiotherapy, School of Health Sciences, University of Zambia, Lusaka

Introduction

Traumatic spinal cord injuries cause long-term disability and functional impairment. Timely and proper surgical treatment improves neurological recovery and functional outcomes. However, in low-resource setting countries, surgical intervention is usually delayed raising concerns about the recovery of patients. Hence, this study investigated the neurological improvement of patients undergoing surgery for traumatic spinal cord injuries at the University Teaching Hospital in Lusaka, Zambia.

Methods

This was a retrospective study that included all eligible patients with traumatic spinal cord injury managed surgically at the University Teaching Hospital between 2018 and 2022. The study assessed neurological improvement by comparing the American Spinal Injury Association’s neurological grading before surgery to that at discharge. Data was analysed using Stata 17, and the level of significance was set at 5%.

Results

Out of the 96 patients in the study, 45.8% showed neurological improvement of at least one grade after surgery. Patients with thoracic injuries showed lower improvement rates (25.0%) than those with cervical (55.0%) or lumbar injuries (65.0%), while those with incomplete injuries showed higher improvement rates (78.7%) (p <0.05). Thoracic injuries were associated with reduced neurological improvement (AOR 0.21; 95% CI: 0.04 – 0.95, p = 0.043), while incomplete injuries were associated with higher neurological improvement (AOR 18.58; 95% CI: 6.11 – 56.51, p < 0.001).

Conclusion

Neurological improvement was poor for thoracic injuries and complete injuries, highlighting the necessity for further investigation into the specific structural features and mechanisms of injury that contribute to poor neurological improvement in thoracic injuries and the identification of effective recovery approaches for these patients.

Keywords: surgery, traumatic spinal cord injury, neurological improvement, surgical intervention, recovery rate, ASIA grade

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