TITLE:
No Independent Association Detected between Lesion Morphology and Neurological Outcome: AOSpine and ASIA Assess Distinct Dimensions in a West African Cohort of 366 Traumatic Spinal Injuries
AUTHORS:
Faozo Stephane Landry Teti, Koffi Yves Soress Dongo, Konan Serge Yao, Yao Bernard Fionko, Kouadio Jean-Baptiste Keke, Aderehime Haidara
KEYWORDS:
Classification, Côte d’Ivoire, Prognosis, Spinal Cord Injuries, Spinal Injuries
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.16 No.4,
September
28,
2026
ABSTRACT: Background and Objective: The AOSpine classification describes the morphology of traumatic spinal injuries, whereas the ASIA grade assesses neurological impairment. The prognostic value of lesion morphology itself remains debated and has rarely been studied in African cohorts. The objective was to determine whether the AOSpine classification retains prognostic value after adjustment for ASIA grade. Methods: Single-centre cohort of 366 traumatic spinal injuries managed at Bouaké Teaching Hospital, Côte d’Ivoire, reported according to STROBE. Injuries were classified using the AOSpine thoracolumbar and subaxial cervical systems and grouped into types A, B and C. Bivariate comparisons, adjusted logistic regression and analysis stratified by spinal segment were performed. Results: Injuries were type A in 34.7%, type B in 21.9% and type C in 43.4%. AOSpine type was associated with dislocation, disco-ligamentous injury and cord compression (p Conclusion: The AOSpine classification accurately describes the mechanical severity of the injury, but neither an independent prognostic association nor a substantial incremental predictive gain beyond ASIA grade was detected, and the confidence intervals remain compatible with modest effects. The two classifications assess distinct dimensions and should be documented jointly.