Surgical outcomes of patients with traumatic spinal cord injuries in three referral hospitals in Cameroon: Retrospective study

Abstract

Background: Traumatic spinal cord injuries (TSCIs) represent a major global health challenge affecting survival and quality of life. In resource-limited settings, their management is complicated due to restricted healthcare access and a high incidence of complications. This study aimed to evaluate the surgical outcomes of patients with TSCIs in three referral hospitals in Cameroon. Materials and methods: This retrospective observational study with an analytical approach, focused on patients who underwent surgical treatment for TSCIs from January 2019 to December 2023. Results: The mean age of the 240 patients was 38.54±13.48 years with a male predominance of 83.8%. Road traffic accidents accounted for 62.5% of cases. At admission, 82.5% of patients presented with neurological deficits. The median time from injury to surgery was 120 hours (IQR 48 hours. Major complications included pressure ulcers (113 cases, 50.2%) and urinary tract infections (45 cases, 20%), with an overall 1-year post-surgical mortality rate of 16.8%. Age >50 years, cervical injury level, severe initial neurological deficits, and the presence of in-hospital complications were identified as poor prognostic factors while. Frankel C and D grades at admission and surgical intervention within 72 hours post-injury predicted favourable outcomes. Conclusion: Early surgical intervention and less severe neurological status at admission are associated with better outcomes following TSCI in resource-limited settings. Improving early access to specialized care and addressing in-hospital complications may significantly reduce mortality and enhance neurological recovery.