Reintegration into Society of Patients with Complete Cervical Spine Injuries in Nigeria

Background: Reintegration into society following complete cervical spinal cord injury (SCI) is a multidimensional challenge, particularly in low-resource settings. This study assessed the level of reintegration among patients with complete cervical SCI in Nigeria and identified predictors of favourable outcomes across medical, functional, environmental, and psychological domains. Methods: A cross-sectional study of 87 patients with complete cervical SCI (ASIA A) who were discharged from the National Orthopaedic Hospital Dala, Kano, between January 2020 and December 2024 was conducted. Reintegration was assessed across four domains: (i) medical and physiological (respiratory management, bowel management, pressure ulcer prevention); (ii) functional independence (caregiver training, mobility equipment, environmental control units); (iii) environmental and social support (home accessibility, accessible transport, financial and social resources); and (iv) psychological readiness (mental health, self-efficacy). Multivariate logistic regression identified predictors of favourable reintegration. Results: Of 87 patients (55 male, 32 female), all required respiratory and bowel management. Pressure ulcer prevention was achieved in 43 patients (49.4%). Mobility equipment was available to 63 patients (72.4%). Only 3 patients (3.4%) had home accessibility modifications; none had accessible transport or caregiver training. Adequate financial and social resources were reported by 21 patients (24.1%). Mental health was adequate in 33 patients (37.9%), and self-efficacy was present in 12 patients (13.8%). Independent predictors of favourable reintegration included male sex (OR 3.4, 95% CI: 1.2–9.6), younger age (<40 years) (OR 2.8, 95% CI: 1.1–7.1), and adequate financial resources (OR 5.6, 95% CI: 2.1–14.9). Conclusions: Reintegration following complete cervical SCI in Nigeria is profoundly inadequate across all domains. Male sex, younger age, and financial resources are significant predictors of favourable outcomes. A comprehensive, multi-sectoral rehabilitation policy is urgently needed.