Charges associated with traumatic spinal cord injury management and their relationship to outcomes across Nigerian geopolitical zones: a multicentre study

A multicentre, retrospective observational study was conducted in tertiary hospitals across the six geopolitical zones of Nigeria: North Central (NC), North East (NE), North West (NW), South East (SE), South South (SS), and South West (SW). Centres were selected based on their capacity to manage spinal cord injuries, with at least one neurosurgeon or orthopaedic surgeon on staff. A structured data collection proforma was distributed to participating neurosurgeons capturing institution characteristics (ownership type, location, referral coverage), treatment charges (cervical vs. thoracolumbar, operative vs. non-operative), time intervals (injury to initial care, injury to surgery), clinical outcomes (mortality, ASIA grade at admission and discharge), and treatment modalities utilised.