OBJECTIVE: To identify delays for surgery to stabilize subaxial cervical fractures and the main reasons for them across Latin America. METHODS: This is a retrospective multicenter cohort study of patients surgically treated for subaxial cervical fractures from 13 spine centers across Latin America from January 1, 2014 to January 1, 2023. Causes of delay to surgery beyond 24 hours were documented. RESULTS: We included 529 patients from 13 institutions in Latin American countries
408 (77.1%) males and 121 (22.9%) females with a mean age of 43.4 (standard deviation = ±16.2). Predominantly caused by traffic accident (n = 256
48.4%), followed by fall from height (n = 233
44%). Mostly, suffered type C fractures (n = 348
65.8%) and/or neurological injury (n = 384
72.6%). The time from admission to surgery was >
72 hours in 70% of the patients included (n = 375
70.9%). More than 45% waited longer than a week (n = 257
48.6%) for spine surgery. Only 12.5% (n = 66) of the patients received surgery in the first 24 hours from admission. The primary reasons for the surgical delay were the necessity for other surgical procedures (n = 161
34.8%), the unavailability of surgical implants (n = 60
13.0%), patient clinical instability (n = 55
11.9%), and delays in referral (n = 38
8.2%). CONCLUSIONS: We documented significant and concerning delays in providing spinal decompression and stabilization surgery to patients with cervical spine fractures. Only 17% of patients have surgery in the recommended time <
24 hours, more than half of the patients must wait for more than 72 hours, and nearly half of patients wait for longer than a week.