Neurological Recovery Following Surgical Intervention in Patients with Traumatic Spinal Cord Injury at the University Teaching Hospital in Zambia
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 abo...
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Knowledge E
2024-12-01
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| Series: | Journal of Spine Practice |
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| Online Access: | https://knepublishing.com/index.php/jsp/article/view/17060 |
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| author | Munosiya Mulemwa Joseph Lupenga Martha Banda-Chalwe |
| author_facet | Munosiya Mulemwa Joseph Lupenga Martha Banda-Chalwe |
| author_sort | Munosiya Mulemwa |
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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.
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| format | Article |
| id | doaj-art-81b97da5b778414caaa0bcbf667efd53 |
| institution | DOAJ |
| issn | 2789-9454 2789-9462 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Knowledge E |
| record_format | Article |
| series | Journal of Spine Practice |
| spelling | doaj-art-81b97da5b778414caaa0bcbf667efd532025-08-20T02:59:22ZengKnowledge EJournal of Spine Practice2789-94542789-94622024-12-014110.18502/jsp.v4i1.17060Neurological Recovery Following Surgical Intervention in Patients with Traumatic Spinal Cord Injury at the University Teaching Hospital in ZambiaMunosiya Mulemwa0Joseph Lupenga1Martha Banda-Chalwe2Department of Physiotherapy, School of Health Sciences, University of Zambia, LusakaDepartment of Epidemiology and Biostatistics, School of Public Health, University of Zambia, LusakaDepartment 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. https://knepublishing.com/index.php/jsp/article/view/17060surgerytraumatic spinal cord injuryneurological improvementsurgical interventionrecovery rateASIA grade |
| spellingShingle | Munosiya Mulemwa Joseph Lupenga Martha Banda-Chalwe Neurological Recovery Following Surgical Intervention in Patients with Traumatic Spinal Cord Injury at the University Teaching Hospital in Zambia Journal of Spine Practice surgery traumatic spinal cord injury neurological improvement surgical intervention recovery rate ASIA grade |
| title | Neurological Recovery Following Surgical Intervention in Patients with Traumatic Spinal Cord Injury at the University Teaching Hospital in Zambia |
| title_full | Neurological Recovery Following Surgical Intervention in Patients with Traumatic Spinal Cord Injury at the University Teaching Hospital in Zambia |
| title_fullStr | Neurological Recovery Following Surgical Intervention in Patients with Traumatic Spinal Cord Injury at the University Teaching Hospital in Zambia |
| title_full_unstemmed | Neurological Recovery Following Surgical Intervention in Patients with Traumatic Spinal Cord Injury at the University Teaching Hospital in Zambia |
| title_short | Neurological Recovery Following Surgical Intervention in Patients with Traumatic Spinal Cord Injury at the University Teaching Hospital in Zambia |
| title_sort | neurological recovery following surgical intervention in patients with traumatic spinal cord injury at the university teaching hospital in zambia |
| topic | surgery traumatic spinal cord injury neurological improvement surgical intervention recovery rate ASIA grade |
| url | https://knepublishing.com/index.php/jsp/article/view/17060 |
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