World Neurosurgery: X · Published 2026-01-01 · DOI 10.1016/j.wnsx.2026.100570
Background: Primary spinal cord tumors (PSCTs) present diagnostic and management challenges, particularly in low-resource settings. This study assessed current diagnostic and treatment practices, with a specific focus on the use of standardized management algorithms for PSCTs in Yaoundé, Cameroon. Methods: A cross-sectional analysis was conducted on 67 consecutive patients with newly diagnosed PSCTs in Yaoundé between November 1, 2011, and December 31, 2023. Data collected included demographics (mean age 43.28 ± 9.8 years; 34 % female), clinical parameters (median admission delay 405 days, interquartile range 248–541; 13.4 % insured), tumor histology, and WHO grade. Five predefined management algorithms were used to classify care pathways, incorporating diagnostic imaging, staging, surgical intervention, and chemotherapy. We evaluated completion of the algorithmic care pathway and applied multivariate logistic regression to identify factors associated with adherence. Results: Tumor histologies were ependymoma (41.2 %), meningioma (23.5 %), plasmacytoma/multiple myeloma (19.6 %), and other types (15.7 %). WHO grade II tumors predominated (76.5 %). Overall, 76.1 % of patients completed the prescribed algorithmic care pathway. In multivariate analysis, strong family support was the strongest predictor of algorithm completion (odds ratio 12.6, 95 % confidence interval 2.45–64.8 for high vs. low support). Age, gender, and insurance status were not significantly associated with completion of care. Given the limited sample size and wide 95 % confidence intervals, these associations should be interpreted as exploratory and hypothesis-generating rather than definitive. Conclusion: In Yaoundé, Cameroon, PSCT diagnosis and management were characterized by prolonged delays and limited insurance coverage, yet standardized algorithmic care was largely achievable. Importantly, family support substantially influenced algorithm completion. These findings highlight the need to integrate social support mechanisms and improve access to diagnostic and therapeutic resources to optimize PSCT care in low-resource settings.
Abstract from DOAJ. Public domain (CC0 1.0).
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