International Journal of Clinical Science and Medical Research

Background: Falls while carrying heavy loads on the head are an under-recognised mechanism of cervical spinal cord injury (CSCI) in Northern Nigeria. This study evaluated the clinical profile, outcomes, and predictors of good outcome in patients sustaining CSCI through this mechanism at a tertiary centre in Kano.

Methods: A retrospective review of 16 male patients managed between January 2019 and June 2025 was conducted. Data on age, load weight, neurological level, completeness of injury, treatment modality, neurological improvement, and mortality were extracted. An aggregate outcome score was constructed from neurological improvement (yes = 1) and survival (alive = 1), with a total score of 2 defined as good outcome and 0–1 as poor outcome.

Results: All patients were male (mean age 34.3 years). Loads ranged from 75–100 kg. C4 was the commonest level (8/16, 50%), followed by C5 (6/16, 37.5%). Ten patients (62.5%) had complete injuries and six (37.5%) incomplete injuries. Seven patients were managed conservatively and nine surgically. Among incomplete injuries, three improved by more than one neurological level and none died. Among complete injuries, three died. All deaths (3/9, 33.3%) occurred in the surgical group. Incomplete injury (p = 0.008) and conservative management (p = 0.015) were associated with good outcome.

Conclusion: CSCI from head-loading falls predominantly affects young working-age males and carries a high mortality when the injury is complete. Incomplete injury and non-surgical management predicted good outcome. Preventive strategies targeting head-loading practices are urgently needed.

cervical spinal cord injury, head loading, falls, outcome predictors, Nigeria, Kano

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