Spine Trauma Resource Priorities in Sub-Saharan Africa: A Delphi Approach.

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Public Health

Background:

• Spine trauma poses a significant disability and public health challenge in low- and middle-income countries (LMICs) due to limited resources and training.
• Optimal spine trauma care necessitates substantial resources and specialized training, which are often scarce in sub-Saharan Africa.

Purpose of the Study:

• To identify and prioritize the essential resource needs for spine surgeons in sub-Saharan Africa.
• To guide resource allocation for improving the quality and safety of spine trauma care in the region.

Main Methods:

• A three-round Delphi study using electronic surveys was conducted.
• Participants were recruited through the Continental Association of African Neurosurgical Societies (CAANS) and College of Surgeons of East, Central, and Southern Africa (COSECSA) networks.
• Consensus on resource priorities was established based on participant ratings.

Main Results:

• Fifty-one critical resource items reached consensus among participants.
• The highest-priority needs identified were braces/c-collars, spine training for emergency physicians and surgeons, and access to surgical implants.
• Advanced technologies such as microscopes, endoscopes, and navigation systems were not prioritized by consensus.

Conclusions:

• Focusing on essential resources for timely spine stabilization is crucial for improving spine trauma care in sub-Saharan Africa.
• Investment in basic equipment and comprehensive training should precede the acquisition of advanced surgical technologies in resource-limited settings.
• Addressing these prioritized needs can significantly reduce the burden of disability from traumatic spine injuries in the region.