Background: Computed tomography (CT) is the imaging modality of choice for evaluating spinal trauma, providing rapid assessment of bone injury, canal compromise, and instability. This study describes CT findings in spinal trauma patients at a Nigerian tertiary centre and relates these findings to surgical intervention and outcomes.

Methods: A retrospective cohort study of 309 patients with spinal trauma who underwent CT imaging at the National Orthopaedic Hospital Dala, Kano, from January 2019 to June 2025 was conducted. Injury patterns, vertebral morphology, canal compromise, and associated abnormalities were documented. Correlation with surgical intervention and outcomes was assessed.

Results: Road traffic accidents were the predominant mechanism (76.4%). Males comprised 78.9% of patients, with a mean age of 36.3±14.2 years. Cervical spine injuries were most common (44.3%), followed by thoracic (31.7%) and lumbar (24.0%). Common CT findings included vertebral body compression fractures (41.4%), burst fractures (28.2%), facet dislocations (18.1%), and canal compromise by retropulsion (34.6%). CT identified surgically significant findings in 43.0% of patients. Patients with canal compromise >50% had higher rates of surgical intervention (78.5% vs 32.4%, p<0.001). Favorable outcomes were achieved in 58.6% of surgical patients compared with 32.4% of non-surgical patients (p=0.008).

Conclusions: Cervical spine injuries predominate in Nigerian spinal trauma patients, with burst fractures and canal compromise being the most significant findings driving surgical intervention. CT is essential for identifying surgical candidates, and patients with significant canal compromise benefit from surgical decompression and stabilisation.