Search Results (123)

Background/Objectives: The restoration of structurally weakened roots remains a clinical challenge. This in vitro study evaluated the fracture resistance, failure pattern, and stress distribution of weakened bovine roots restored with two glass fiber post systems under different remaining root dentin thicknesses. Methods: Sixty bovine incisor roots were divided into six groups (n = 10): G1, 2 mm of remaining root dentin without a post; G2, 3 mm without a post; G3, 2 mm with an Exacto post; G4, 3 mm with an Exacto post; G5, 2 mm with a Splendor-SAP post; and G6, 3 mm with a Splendor-SAP post. Specimens underwent root canal treatment and standardized restoration, followed by 1,200,000 mechanical cycles at 88 N and 3.8 Hz and fracture testing at 45°. Finite element models were subjected to an 88 N oblique load. Fracture resistance was analyzed using Welch’s one-way ANOVA followed by Games–Howell post hoc comparisons, whereas failure patterns were analyzed using the Fisher–Freeman–Halton exact test. Results: Fracture resistance differed significantly among groups (p < 0.001). G1 (88.7 N) and G2 (95.6 N) showed the lowest and statistically similar values; G3 (670.9 N) and G5 (691.9 N) showed intermediate and statistically similar values; and G4 (786.2 N) and G6 (784.8 N) showed the highest and statistically similar values. Failure-pattern distribution was not significantly associated with the experimental groups (p = 0.582). Finite element analysis showed stress concentration predominantly in the cervical region of the root, with G5 showing the highest maximum principal stress in root dentin. Conclusions: Glass fiber posts substantially increased the fracture resistance of weakened roots. Among post-restored specimens, roots with 3 mm of remaining dentin showed higher fracture resistance than those with 2 mm, whereas no significant difference was observed between the Exacto and Splendor-SAP systems under the same remaining-dentin condition. Full article

Traumatic cervical spine injury in children and adolescents is uncommon but may cause major disability and prolonged critical care. This retrospective descriptive cohort characterizes patients aged 18 years or younger admitted to the Neurosurgical Intensive Care Unit (ICU) of a tertiary trauma center in New Delhi, India, during 2008–2015. Discharge status was classified as favorable (American Spinal Injury Association [ASIA] Impairment Scale D–E) or unfavorable (ASIA A–C or in-hospital death). We used chi-square tests with Yates’ continuity correction, with unadjusted odds ratios (ORs) and 95% confidence intervals (CIs). Among 112 patients, 83.0% were male, 85.7% were aged 9–18 years, and 77.7% had spinal canal compromise. Forty-seven patients (42.0%) had favorable and 65 (58.0%) had unfavorable discharge status, including nine in-hospital deaths (8.0%). Favorable status was associated with absence of spinal canal compromise (OR 6.67, 95% CI 2.40–18.54) and absence of the composite ICU complication indicator (OR 6.44, 95% CI 2.61–15.93), and with fracture rather than subluxation, absence of tracheostomy, and favorable admission ASIA category. No multivariable adjustment was performed; these exploratory, unadjusted associations do not establish independent or causal effects. The cohort provides descriptive data from an under-reported tertiary trauma setting and identifies variables for prospective multicenter study. Full article

Background/Objectives: Pulp necrosis in immature permanent teeth arrests root development, leaving an open apex, thin, divergent dentinal walls, and an unfavorable crown-to-root ratio that predisposes the tooth to fracture and complicates endodontic management. An apical barrier using hydraulic calcium silicate cements has become the first-line orthograde approach for these teeth when regenerative procedures are not indicated or feasible. This narrative review synthesizes current evidence on the complete clinical pathway for apical barrier placement in immature permanent teeth, with particular emphasis on the procedural determinants of barrier formation. It also critically appraises where the evidence is robust and where it remains uncertain. Methods: The relevant English-language literature on root development, the etiology of pulp necrosis in immature teeth, diagnosis, isolation, apical barrier methods, calcium silicate materials, and treatment outcomes was reviewed through targeted searches of PubMed/MEDLINE, Scopus, Web of Science, the Cochrane Library, and Google Scholar through June 2026. The literature search was completed in June 2026; therefore, studies published after this date were not included. Evidence was narratively synthesized according to the clinical sequence of diagnosis, treatment selection, isolation, disinfection, barrier formation, restoration, follow-up, and evidence gaps. Throughout, an explicit distinction was maintained between clinical and laboratory evidence. Results: Sensibility testing is widely considered unreliable in immature teeth, complicating diagnosis. Isolation is often challenging because of traumatic crown loss. Successful treatment depends on adequate chemical disinfection, judicious minimal instrumentation, a well-condensed apical barrier of at least 4–5 mm, and a definitive coronal seal that also addresses the weak cervical dentin. Calcium silicate cements—principally MTA, Biodentine, and pre-mixed bioceramic putties—achieve high clinical success. Observational evidence further suggests, as a hypothesis requiring prospective confirmation, that material choice may be less decisive than operator experience and the quality of the coronal restoration. Conclusions: Apical barrier placement with hydraulic calcium silicate cements is a predictable orthograde preservation approach for non-vital immature permanent teeth, particularly when regenerative endodontic procedures are not indicated, not feasible, or unlikely to yield predictable clinical outcomes. Well-designed randomized clinical trials with standardized reporting are needed. Full article

Traumatic cervical spine fractures (CSFxs) require timely diagnosis due to associated morbidity. Artificial intelligence (AI)-based decision support systems have been proposed to improve imaging workflow efficiency. However, their performance in non-trauma settings remains unclear. This study evaluated the diagnostic performance of the AIDOC decision support system (DSS) for detecting CSFxs in a non-trauma academic community hospital using a retrospective analysis of 1812 cervical spine CT scans, with radiologist interpretation as the reference standard. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated for fracture detection and heatmap-based localization. The AI system demonstrated a sensitivity of 72.2% and specificity of 98.1%, with an accuracy of 97.9%. In the context of low fracture prevalence (0.99%), PPV was low (27.7%), while NPV was high (99.7%). Heatmap-based localization showed reduced sensitivity (43.8%) despite high specificity (97.5%). These findings demonstrate high specificity and NPV, with lower sensitivity for localization and low PPV in a low-prevalence setting. Prospective multi-institutional studies are required to further validate these diagnostic performance metrics and assess generalizability across diverse clinical settings and imaging protocols. Full article

Background/Objectives: Early mortality risk stratification after CT-confirmed cervical spine fractures remains clinically challenging in patients with major trauma. Imaging establishes a structural diagnosis, but it does not fully capture early physiological deterioration. This study aimed to develop and internally validate a prognostic model for in-hospital mortality and evaluate whether a MAP-derived Shock Index provides incremental prognostic information beyond routinely available clinical variables and the Injury Severity Score (ISS). Methods: This retrospective single-center cohort study included 131 adults with CT-confirmed cervical spine fractures and ISS ≥ 15 who were admitted to a tertiary trauma center between 2013 and 2023. The MAP-derived Shock Index was calculated as heart rate divided by estimated systolic blood pressure, where estimated systolic blood pressure was defined a priori as 1.5 × MAP. Four prespecified logistic regression models were evaluated: a base clinical model, base plus MAP-derived Shock Index, base plus ISS, and base plus MAP-derived Shock Index plus ISS. Discrimination, Brier score, calibration, bootstrap internal validation, and decision curve analyses were performed. Results: The in-hospital mortality rate was 22.9% (30/131). The base plus MAP-derived Shock Index model achieved an apparent AUC of 0.93 and an optimism-corrected AUC of 0.91. The MAP-derived Shock Index provided incremental prognostic information beyond the ISS; as an individual predictor, its AUC was 0.82 compared with 0.74 for the ISS. With each 0.1-unit increase, the MAP-derived Shock Index was associated with higher odds of in-hospital mortality. Decision curve analysis suggested a higher apparent net benefit across clinically relevant thresholds. Conclusions: In this internally validated retrospective cohort, the MAP-derived Shock Index complemented clinical and ISS-based assessments for early in-hospital mortality risk stratification after CT-confirmed cervical spine fracture. The index is not the conventional SBP-based Shock Index, and the model requires external multicenter validation before clinical use. Full article

Objectives: To evaluate the influence of implant–abutment connection design, implant diameter, and simulated marginal bone loss on fracture resistance and failure patterns of dental implant systems. Materials and Methods: A total of 180 implant–abutment assemblies were tested, including Morse taper (MT) and internal hex (IH) connections with diameters of 3.5, 4.0, and 5.0 mm. Implants were embedded at two simulated bone levels (0 and 3 mm) and loaded at 30° until failure, in accordance with ISO 14801:2015. Fracture resistance (N) was analyzed using three-way ANOVA. Results: Connection type, implant diameter, bone level, and their interactions significantly affected fracture resistance (p < 0.001). Internal hex implants showed a marked diameter-dependent increase in resistance and greater reduction under simulated bone loss, particularly in reduced diameters. In contrast, Morse taper implants demonstrated similar resistance values regardless of implant diameter or bone level. Failure patterns also differed between systems: internal hex implants exhibited cervical implant fractures in reduced diameters, whereas Morse taper implants showed progressive abutment deformation and/or abutment fracture without implant body fracture. Conclusions: Implant fracture resistance is strongly influenced by implant–abutment connection geometry. Within the limitations of this static in vitro study, MT systems demonstrated diameter-independent mechanical stability and prosthetic-controlled failure patterns, whereas IH systems were highly sensitive to diameter reduction and simulated bone loss. Full article

Objective: This study aims to report a clinical case involving posterior fixation combined with anterior transoral plate osteosynthesis in the management of chronic Gehweiler IIIb atlas fracture–dislocation, thereby providing a reference for similar cases. Methods: A patient with atlas fracture–dislocation following a fall injury underwent surgical intervention. Preoperative diagnosis confirmed Gehweiler IIIb fracture with right atlantoaxial lateral mass dislocation. The treatment protocol involved posterior reduction, instrumentation, and anterior transoral screw–plate fixation. Results: The postoperative recovery was uneventful, with significant alleviation of cervical pain. The most recent follow-up assessment revealed favorable osseous union and appropriate stabilization of the internal implants. The VAS score decreased from 4 preoperatively to 0 postoperatively, and the NDI decreased from 64% to 16%, concurrent with a notable enhancement in the patient’s quality of life. Conclusions: Combined posterior fixation and anterior transoral plate osteosynthesis demonstrates efficacy in ameliorating clinical manifestations and facilitating osseous consolidation in cases of chronic Gehweiler IIIb atlas fracture–dislocation. This surgical strategy demonstrates favorable therapeutic outcomes for refractory atlas fractures and warrants clinical application in analogous scenarios, but still requires extensive clinical verification. Full article

Introduction: Posterior cervical fusion is commonly performed for cervical spine instability and fractures. However, dural injury may result in cerebrospinal fluid leakage, pseudomeningocele, and, rarely, hydrocephalus. These complications may lead to substantial neurological deterioration and functional decline. We report a rare case of severe cognitive impairment and dysphagia caused by postoperative CSF leakage-associated hydrocephalus after C1–2 fusion and highlight the role of comprehensive rehabilitation in functional recovery. Case presentation: A 67-year-old woman sustained a type III odontoid fracture and was initially managed with halo-vest immobilization. Because of fracture nonunion, posterior C1–2 fusion was performed. One month after surgery, she developed progressive mental status deterioration, confusion, and severe functional impairment. Brain computed tomography revealed progressive hydrocephalus, and cervical spine magnetic resonance imaging demonstrated a large posterior fluid collection consistent with pseudomeningocele. Revision surgery and ventriculoperitoneal shunt placement were performed. However, the patient remained bedridden with persistent vomiting, severe cognitive impairment, dysphagia requiring nasogastric tube feeding, and generalized deconditioning. Three months after revision surgery, her neurological condition stabilized and rehabilitation was initiated. Intensive and individualized rehabilitation, including cognitive rehabilitation, swallowing therapy was implemented. After three months of rehabilitation, the patient demonstrated gradual improvement in cognitive function, swallowing function, and mobility, ultimately achieving independent standing and ambulation using a walker. Conclusions: Postoperative CSF leakage-associated hydrocephalus and pseudomeningocele may lead to severe cognitive, swallowing, and functional impairments beyond structural complications alone. Comprehensive, individualized rehabilitation should be considered an essential component of care to maximize neurological and functional recovery. Full article

Background: Dislocations and fracture-dislocations of the lower cervical spine represent complex injuries with a high risk of neurological damage. Especially in the presence of a confirmed traumatic disc lesion, an anterior surgical approach is described as favoured in the literature. However, studies show that with sufficient reduction technique, even in the presence of a confirmed disc protrusion, posterior stabilization can be considered a safe therapeutic option. The aim of this study is to analyze anterior and posterior treatment of dislocations and fracture-dislocations of the subaxial cervical spine with regard to neurological and radiological outcomes. Methods: In our monocentric cohort study, we investigated the immediate postoperative radiological and neurological outcome depending on the chosen surgical approach and the presence of a disc protrusion. Patients treated at our centre between January 2005 and June 2025 were included. Patients with preoperative complete spinal cord injury were excluded. Neurological status was assessed using the ASIA score preoperatively at admission and postoperatively at discharge or prior to staged surgery. Results: A total of 92 patients were included in the study. Most patients showed an ASIA score C (33.7%). A total of 49 patients (53.3%) were operated anteriorly and 42 patients (45.6%) posteriorly. One patient was primarily stabilized bilaterally. Nine patients initially treated anteriorly had to be secondarily stabilized additionally from posterior. In both groups, neurological deterioration occurred in one case. All other patients remained stable on the ASIA score or improved by at least one point on the scale. Conclusions: The findings provide evidence in favour of a personalized, pathology-oriented approach to lower cervical spine fracture-dislocations rather than selecting the surgical approach based solely on the presence of traumatic disc protrusion. Further prospective studies are needed to validate these observations. Full article

Treatment of severely injured patients is challenging, and timely reading of whole-body computed tomography (WBCT) images therefore crucial. Artificial intelligence is increasingly used to prioritize and detect acute injuries in this context. Algorithms focusing on the cervical spine and compression fractures have been deployed successfully. However, tools for whole spine assessment and the entirety of fracture morphologies are lacking. We aimed to investigate the capabilities of an algorithm to detect spine fractures on WBCTs and factors contributing to the difficulties in its development. A version 1.0 (v1) of the algorithm was previously trained with 454 cervical spine fractures using a U-Net via four-fold cross-validation to segment spine fractures and the spine via a multi-task loss. Further training expanded towards whole spine assessment with additional annotated fractures (Cohort 1) of the cervical (n = 50), thoracic (n = 30), and lumbar spine (n = 20), resulting in version 2.0 (v2). Baseline was set to reach the highest sensitivity at a maximum of five false positives per case. Version 1.0 was tested on Cohort 1 and both versions were compared on prospectively collected real-world data (Cohort 2, n = 712 WBCTs). An additional systematic review served to compare the algorithmic performance against the state-of-the-art. Version 1.0 showed promising performance not only for the cervical but also the thoracic and lumbar spine due to generalization (sensitivities ranging between 60% and 87%). Version 2.0 also achieved decent sensitivities for Cohort 2 (sensitivities ranging between 77% and 85%) but generated an abundance of false positives. Various reasons led to false positive results; for Version 2.0, the trabecular structure itself provoked false alerts. Variances in training and test data (image quality, dose, reconstructions), heterogeneity of fractures and anatomies, plus the size of training sets explain some difficulties during algorithm development. Only five other groups described their work on whole-spine fracture detection, encountered similar difficulties, and have also failed to develop a clinically deployable tool. Spine fracture detection on WBCT is feasible, but multiple factors hinder the development of commercially available AI tools. Expansion and the improved design of training cohorts are necessary for further development and simulation of real-life conditions. Full article

Background: Fractures of the upper cervical spine are challenging to treat due to their proximity to critical neurovascular structures and the need for immediate, stable fixation. Open posterior fixation remains the standard but is associated with soft-tissue disruption and morbidity. Minimally invasive, navigation-assisted pedicle screw fixation represents a viable alternative for older populations, significantly reducing surgical morbidity and tissue trauma. The present study evaluates the accuracy, safety, and perioperative outcomes of minimally invasive navigated posterolateral C1–C2 fixation. Methods: We conducted a retrospective consecutive case review of 51 patients who underwent minimally invasive C1–C2 screw fixation between 2019 and 2024. All procedures were performed using intraoperative O-arm imaging and StealthStation S8 navigation. Screw placement accuracy was assessed using the Bredow modification of the Gertzbein–Robbins and Heary classifications. Perioperative data, including operative time, screw dimensions, radiation dose, complications, and hospital stay, were recorded. Results: Fifty-one patients were included in the study. A total of 212 screws were placed. According to Gertzbein–Robbins grading, 92.4% were Grade A, 6.6% were Grade B, and 1% were Grade C. According to Heary grading, 95% were Grade I and 5% were Grade III. No vertebral artery injuries, new neurological deficits, or intraoperative hardware failures occurred. The mean screw lengths were 33.2 mm (SD = 3.38 mm) (C1) and 32 mm (SD = 4.30 mm) (C2). The mean operative time was 128 min (SD = 52.95 min). The mean radiation dose was 629.16 mGy·cm² (SD = 372.2 mGy·cm²). One superficial wound infection occurred. The median postoperative NRS was 4 (IQR: 4–5). The mean hospital stay was 4.21 (SD = 3.77) days. Conclusions: Our findings demonstrate that the presented approach for C1–C2 fixation is a highly accurate and safe alternative to open posterior fixation for upper cervical fractures. Full article

Background/Objectives: Posterior C1–C2 fusion is commonly used for unstable traumatic odontoid injuries, but it is less commonly used for patients who initially undergo nonoperative management and later require salvage fusion. This study compared hospital length of stay, short-term complications, and postoperative radiographic alignment between salvage posterior C1–C2 fusion after failed nonoperative management and primary posterior C1–C2 fusion. Materials and Methods: A retrospective cohort study was performed of 106 adult patients who underwent posterior C1–C2 instrumented fusion for traumatic cervical spine injuries from 2011 to 2023. Patients were stratified into the salvage fusion group after radiographic nonunion following attempted nonoperative management with external immobilization or the primary fusion group, who underwent initial surgical management. The primary outcome was hospital length of stay. Secondary outcomes included postoperative radiographic alignment, screw loosening, hardware failure, revision surgery, and 30-day emergency department visits. Propensity score matching and full-cohort augmented inverse probability weighting were used to account for baseline differences between groups. Results: Twenty-seven patients underwent salvage fusion and 79 underwent primary fusion. Propensity score matching produced 25 matched pairs. In the matched cohort, salvage fusion was associated with significantly shorter length of stay than primary fusion, with a median of 2 versus 5 days, respectively (p < 0.001). This remained significant in the full-cohort augmented inverse probability weighting analysis, where salvage fusion was associated with a 2.41-day reduction in length of stay (95% CI, −3.63 to −1.19; p < 0.001). Short-term complications were uncommon in both groups, and no clear sign of increased screw loosening, hardware failure, revision surgery, or 30-day emergency department visits was observed in the salvage cohort. Salvage fusion was also associated with lower postoperative C2–C7 lordosis and a greater C1 lamina–occiput distance. Conclusions: Salvage posterior C1–C2 fusion for radiographic nonunion after attempted nonoperative management was not associated with higher short-term complication rates compared with primary fusion. While surgical-admission length of stay was shorter in the salvage cohort, this difference should be interpreted cautiously because salvage and primary fusion occur in different admission contexts and do not reflect the total episode-of-care burden. Early postoperative alignment differences were observed, but these were not correlated with clinical outcomes or longitudinal imaging, and their long-term significance remains unclear. Future multicenter studies should evaluate total healthcare utilization, fusion status, longitudinal alignment, and patient-reported outcomes after salvage C1–C2 fusion. Full article

Background and Objectives: Temporomandibular disorders (TMDs) are prevalent conditions affecting the temporomandibular joint and associated musculature, arising from a complex interplay of biomechanical, neuromuscular, and psychosocial factors. Increasing evidence supports functional interconnections among the TMJ, cervical spine, and shoulder girdle, suggesting that dysfunction in one region may influence others; however, these relationships remain incompletely understood. This study aimed to evaluate the association between scapulohumeral trauma, postural abnormalities, and TMDs, and to assess their evolution following interdisciplinary rehabilitation. Materials and Methods: A retrospective observational study with prospective follow-up was conducted in patients with scapulohumeral fractures associated with TMD and postural abnormalities. Postural parameters and the clinical features of temporomandibular disorders (TMDs) were evaluated at baseline and follow-up using a structured clinical assessment informed by the DC/TMD framework, together with clinical examination, electromyographic analysis, and mandibular mobility measurements. Postural evaluation was performed using digital baropodometric analysis (Free Med™ platform with FreeStep™ software, standard Medica sensor, Rome, Italy. Patients received individualized multidisciplinary treatment, including orthopaedic rehabilitation, occlusal splint therapy, physiotherapy (twice weekly), pharmacological management, and odonto-periodontal care. Statistical analyses were performed using non-parametric tests (p < 0.05). Results: Significant postural improvement was observed (p < 0.01), with the proportion of patients with normal posture increasing from 0% to 22.2% and the proportion with moderate forward lean decreasing from 53.3% to 15.6%. TMD severity decreased progressively across evaluations (Friedman χ² = 72.35, p < 0.01). No statistically significant differences were found between treatment groups with respect to postural outcomes, although descriptive differences in TMD improvement were observed at later evaluation points. Conclusions: Interdisciplinary rehabilitation was associated with significant improvements in both postural alignment and TMD severity. Scapulohumeral trauma may be associated with alterations in TMJ function and overall posture, while multimodal therapy supports functional recovery. Further randomized controlled studies are needed to confirm these findings. Full article

Background: Missed fractures on initial imaging assessments remain a clinically significant source of diagnostic errors in orthopedic and trauma care. AI-assisted imaging tools are increasingly integrated into fracture detection workflows. However, their diagnostic benefits and safety vary substantially across anatomical regions, clinical contexts, and levels of reader experience. Purpose: To synthesize the current evidence on the diagnostic impact of AI-assisted fracture detection and to discuss evidence-informed principles for safe and selective clinical deployment. Methods: A structured narrative synthesis of meta-analyses, multi-reader, multi-case observer studies, and real-world implementation investigations was performed. Diagnostic performance patterns were examined across anatomical regions and levels of reader experience. No quantitative pooling or reanalysis of the primary data was performed. The findings were synthesized across anatomical regions, reader-experience groups, and implementation-relevant clinical contexts. Results: Across studies, AI-assisted interpretation was generally associated with moderate gains in sensitivity and lower missed-fracture rates compared with unaided human reading, while largely preserving specificity. The diagnostic benefit was greatest among less-experienced readers in high-volume emergency settings. Performance was strongly anatomy-dependent: consistent and clinically meaningful improvements were observed for hip and appendicular skeleton fractures; intermediate benefits with increased false-positive burden were reported for wrist and rib fractures; and inferior sensitivity relative to expert interpretation was documented for cervical and vertebral spine injuries. Conclusions: AI-assisted fracture detection improves diagnostic safety when implemented as a structured second-reader tool; however, its effectiveness depends heavily on anatomy. Available evidence supports selective, risk-stratified deployment, guided by anatomy-specific risk considerations and supervised clinical use, rather than indiscriminate or autonomous use, to maximize benefits and minimize patient safety risks in orthopedic and trauma imaging. Full article

Background/Objectives: Traumatic spine injury is a major cause of morbidity and mortality in low- and middle-income countries, yet detailed epidemiologic data from sub-Saharan Africa remain limited. We used a fracture registry to characterize injury patterns, care pathways, and short-term outcomes among patients presenting with traumatic spine injury at a tertiary referral center in Ethiopia. Methods: We performed a retrospective analysis of a prospectively maintained fracture registry at a tertiary referral hospital in Ethiopia from June 2023 to July 2025. Patients with traumatic spine injury were included. Variables included demographics, injury mechanism and context, injury region, AO morphology, neurologic status (ASIA), referral status, mode of transportation, time to presentation, treatment, and 30-day outcomes. Descriptive statistics were used to summarize the cohort. Bivariate associations were assessed using chi-square or Fisher’s exact tests, and crude odds ratios were calculated for prespecified 2 × 2 comparisons. Results: A total of 252 patients were included (mean age: 33.1 ± 13.6 years; 81.3% male). Falls (45.2%) and road traffic accidents (26.2%) were the most common mechanisms, and injuries most often occurred on farms (40.1%) and roads/streets (33.7%). The thoracolumbar (31.3%) and cervical (30.6%) regions were most frequently affected. Complete spinal cord injury (ASIA A) occurred in 36.5% of patients. Most patients were referred (88.5%), 62.7% presented >24 h after injury, and 65.5% were managed non-operatively. Referral status was strongly associated with delayed presentation (OR: 10.49, 95% CI: 3.84–28.64). Thirty-day mortality was 22.2%. Complete SCI (OR: 6.17, 95% CI: 3.23–11.90) and cervical/thoracic injuries (OR: 6.54, 95% CI: 3.12–13.70) were associated with higher mortality. Conclusions: Traumatic spine injury in this Ethiopian cohort disproportionately affected young adults and was marked by severe neurologic injury, delayed presentation, and high early mortality. Full article