{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T03:06:27Z","timestamp":1767927987019,"version":"3.49.0"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Spinal stab wounds (SW) are relatively uncommon and can be both morbid and fatal. The exact role of surgery remains somewhat unclear. This study reviews our institutional experience of spinal SW management and examines the clinical outcome of these patients in a developing world setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study was conducted over a 10\u2010year study period from December 2012\u2013December 2022 at a major trauma center in South Africa. All patients who sustained spinal SW were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred sixty\u2010nine patients with spinal SW were included (male: 87%, mean age: 28\u00a0years, median Injury Severity Score [ISS]: 9). AIS classifications: E (51%), C (18%), A (14%), D (12%), B (4%). Nearly all patients (95%) underwent CT scan and 81% had an MRI. 72% had bony injury and 60% had spinal cord injury. Five percent of all patients underwent surgical intervention. Overall, 5% of patients required intensive care unit (ICU) admission and 9% had one or more complications. Common complications were hospital acquired pneumonia and pressure sores. The overall in hospital mortality rate was 1% (2\/169). Of the 167 patients who survived to hospital discharge, 88% were discharged to spinal rehabilitation centers and the remaining patients were discharged home.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study supports a conservative management in select SW patients, especially in the absence of progressive neurological deficits or spinal instability. Non\u2010operative management aligns well with resource\u2010constrained public healthcare facilities in our environment. Further research should aim to develop context\u2010specific guidelines to refine surgical decision\u2010making and improve outcomes across varied healthcare settings.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12685","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T12:09:30Z","timestamp":1750939770000},"page":"2239-2245","source":"Crossref","is-referenced-by-count":2,"title":["Selective Conservatism in the Management of Spinal Stab Wounds Remains Applicable\u2014A Critical Review of 169 Patients Managed at a Major Trauma Center in South Africa"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8541-5464","authenticated-orcid":false,"given":"Reuben","family":"He","sequence":"first","affiliation":[{"name":"Department of Surgery Faculty of Medical and Health Sciences The University of Auckland  Auckland New 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The University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Surgery Faculty of Medical and Health Sciences The University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuba","family":"Kosna","sequence":"additional","affiliation":[{"name":"Department of Surgery Wellington Regional Hospital  Newtown New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3121-6915","authenticated-orcid":false,"given":"William","family":"Yeung","sequence":"additional","affiliation":[{"name":"Department of Surgery Faculty of Medical and Health Sciences The University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery Royal Adelaide Hospital  Adelaide Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard","family":"Wain","sequence":"additional","affiliation":[{"name":"Department of Surgery University of KwaZulu\u2010Natal  Durban South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wanda","family":"Bekker","sequence":"additional","affiliation":[{"name":"Department of Surgery University of KwaZulu\u2010Natal  Durban South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damian","family":"Clarke","sequence":"additional","affiliation":[{"name":"Department of Surgery University of the Witwatersrand  Johannesburg South Africa"},{"name":"Department of Surgery University of KwaZulu\u2010Natal  Durban South 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