Pattern of spinal cord Injury in young adults: Etiology, level of injury and associated complications.

Abstract

Objective: To determine pattern of spinal cord injury in young adults aged 18–35 years, identify etiologies, most common neurological levels and types of early medical complications. Study Design: Cross Sectional Analytical study. Period: January 2024 to June 2025. Setting: Allama Iqbal Teaching Hospital, DG Khan Medical College, Dera Ghazi Khan. Methods: Three hundred sixty two young adults with imaging-confirmed traumatic spinal cord injury were enrolled consecutively. Demographics, mechanism of injury, ASIA impairment grade, anatomical level, time to presentation, and complications within three months were documented on a structured proforma. Chi-square tests and logistic regression were performed in SPSS version 21.0 to identify predictors of early complications. Results: Males constituted 85.1% of participants (mean age 26.7 ± 5.4 years). Road traffic accidents caused 62.2% of injuries, followed by falls (27.1%), sports injuries (6.6%), and violence (4.1%). Cervical injuries predominated (52.2%), and 63.8% were complete (ASIA A). Complications developed in 67.9%, led by urinary tract infections (29.8%), pressure ulcers (26.0%), neurogenic shock (21.0%), and respiratory failure (18.8%). Cervical level strongly predicted respiratory failure (OR 6.2; 95% CI 3.8–10.1), and complete lesions were linked to pressure ulcers (OR 3.1; 95% CI 2.0–4.8). Conclusion: Traumatic spinal cord injury in young adults of southern Punjab is predominantly caused by road traffic accidents; most frequently involves the cervical spine, and carries a high early complication burden, underscoring the need for targeted prevention strategies and multidisciplinary rehabilitation.