{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T17:06:15Z","timestamp":1784135175073,"version":"3.55.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004695","name":"University of KwaZulu-Natal","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004695","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Spine J"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighty-six patients were included. Thirty-day mortality was 12%. Kaplan\u2013Meier 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ASIA 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00586-026-09876-3","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T06:32:08Z","timestamp":1774247528000},"page":"4524-4531","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mortality following surgical management of traumatic sub-axial cervical spine injuries in a South African tertiary centre"],"prefix":"10.1007","volume":"35","author":[{"given":"Khangelani","family":"Sondovana","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Puddu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter Herman","family":"Mare","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"issue":"4","key":"9876_CR1","doi-asserted-by":"publisher","first-page":"252","DOI":"10.13107\/jocr.2025.v15.i04.5514","volume":"15","author":"V Kumar","year":"2025","unstructured":"Kumar V et al (2025) Factors Affecting Clinical Outcomes in Traumatic Cervical Spine Injuries in Adults: Review of Recent Literature. J Orthop Case Rep 15(4):252\u2013261","journal-title":"J Orthop Case Rep"},{"issue":"1","key":"9876_CR2","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1038\/s41394-020-00334-w","volume":"6","author":"V Madasa","year":"2020","unstructured":"Madasa V et al (2020) Mortality and secondary complications four years after traumatic spinal cord injury in Cape Town, South Africa. Spinal Cord Ser Cases 6(1):84","journal-title":"Spinal Cord Ser Cases"},{"issue":"4","key":"9876_CR3","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1038\/sc.2010.146","volume":"49","author":"RA Cripps","year":"2011","unstructured":"Cripps RA et al (2011) A global map for traumatic spinal cord injury epidemiology: towards a living data repository for injury prevention. 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