Observational studyEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Mortality following surgical management of traumatic sub-axial cervical spine injuries in a South African tertiary centre.
Observational study in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo evaluate 30-day mortality and survival up to five years post injury in surgically treated adults with traumatic sub-axial cervical spine injuries at a South African tertiary centre.
methodsWe performed a retrospective observational study of adults who underwent surgery between 2018 and 2022. Mortality data were obtained from the South African Medical Research Council death registry. Primary outcomes were 30-day mortality and survival up to five years post injury. Univariable logistic regression was used to evaluate factors associated with 30-day mortality, and categorical ASIA-based logistic models were constructed to minimise overfitting. Cox proportional hazards analysis was used to evaluate predictors of survival during follow-up.
resultsEighty-six patients were included. Thirty-day mortality was 12%. Kaplan-Meier estimated overall survival was 83.7% at 1 year and 80.0% at 5 years. Seventeen patients died during follow-up. Univariable analysis identified spinal shock, ASIA grade, Injury Severity Score, and lower respiratory tract infection as factors associate with 30-day mortality. In time-to-event analysis, ASIA grade on arrival was the only factor independently associated with survival. Respiratory failure caused all but one death.
conclusionASIA grade strongly predicted survival in traumatic sub-axial cervical spine injuries. Despite high mortality among patients with severe neurological injury, many patients survive, underscoring the importance of rehabilitation and community reintegration.
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