Presentation, Management, and Outcomes of Thoracic, Thoracolumbar, and Lumbar Spine Trauma in East Africa: A Cohort Study

Traumatic spinal injury (TSI), including spinal column fractures and spinal cord injuries (SCIs), is a major global cause of disability and mortality. The incidence is higher in low- and middle-­income countries (LMICs). LMICs account for only 3.5% of the projected 234 million surgeries despite accounting for more than one-­third of the global population. Approximately 50% to 60% of injuries to the TL region affect the transitional zone (T10-­L2), while 25% to 40% involve the thoracic spine and 10% to 14% affect the lower lumbar spine and sacrum.

• 1
  The study showed that 64.9% of the 257 TL spine trauma patients underwent surgery with a median postadmission day of 17.0. The mortality rate was 1.2%.
• 2
  Patients without neurological deficits and those with longer delays from injury to admission were less likely to have surgery.
• 3
  Univariate analysis showed a significant association between surgery and neurologic improvement; however, this finding was lost in multivariate regression.