International Journal of Clinical Science and Medical Research

Background: Traumatic spinal cord injury (TSCI) is a major cause of neurological disability, particularly among young adults. Surgical management aims to achieve neural decompression, restore spinal alignment, and provide mechanical stability. However, data on neurological outcomes following posterior surgical management of TSCI in Northwestern Nigeria remain limited.

Objective: To determine the pattern, surgical management, and short-term neurological outcomes of patients with traumatic spinal cord injury treated through a posterior surgical approach at a tertiary neurosurgical centre in Sokoto, Northwestern Nigeria.

Methods: This prospective hospital-based descriptive study was conducted at the Regional Centre for Neurosurgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, from 1 November 2023 to 31 October 2024. Seventy-two adult patients with TSCI who underwent posterior surgical intervention were consecutively recruited. Sociodemographic characteristics, mechanisms and levels of injury, surgical procedures, and neurological outcomes were assessed. Neurological status was evaluated using the American Spinal Injury Association (ASIA) Impairment Scale preoperatively and at six months postoperatively. Data were analysed using descriptive statistics.

Results: A total of 72 patients were included, comprising 65 males (90.2%) and seven females (9.8%), with a mean age of 36.0 ± 16.2 years. The most affected age group was 21–30 years (25.0%). Road traffic accidents were the leading cause of injury (60.0%), followed by falls from height (25.0%) and gunshot injuries (15.0%). The thoracic spine was the most frequently affected region (47.2%), followed by the thoracolumbar and lumbar regions (26.4% each). Sixty-one patients (84.7%) underwent posterior spinal decompression and fixation, while 11 (15.3%) underwent decompression alone. Preoperatively, 49 patients (68.1%) had ASIA grade A injuries, nine (12.5%) had grade B injuries, and 14 (19.4%) had grade C injuries. At six months postoperatively, all 49 patients with ASIA grade A injuries remained neurologically unchanged. Among patients with grade B injuries, two (22.2%) improved to grade C, while eight of the 14 patients (57.1%) with grade C injuries improved to grade D. The remaining six patients (42.9%) with grade C injuries showed no neurological improvement.

Conclusion: Traumatic spinal cord injury requiring posterior surgical management predominantly affected young adult males, with road traffic accidents being the leading mechanism of injury. Thoracic injuries were the most common, and most patients presented with complete neurological deficits. At six months postoperatively, neurological improvement was observed more frequently among patients with incomplete spinal cord injuries, whereas no improvement was recorded among those with complete injuries. These findings emphasize the importance of injury prevention, timely access to specialist spinal care, and comprehensive postoperative rehabilitation.

Traumatic spinal cord injury, posterior surgical approach, spinal decompression, spinal fixation, ASIA impairment scale, neurological outcomes, Nigeria

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