Study design: An epidemiological study conducted all over the country.Objective: The present retrospective study was conducted to survey the new traumatic spinal cord injury (SCI) cases during 1992 in Turkey. Setting: Intensive care units, emergency services and departments of orthopaedic surgery, neurosurgery and rehabilitation of state hospitals, rehabilitation centers, military and university hospitals. Methods: Postal questionnaires were used for data collection and the records from medical institutes nation-wide were reviewed for the analysis of the epidemiological factors. Results: Five hundred and eighty-one new traumatic SCI cases were reported in 1992. The annual incidence was found to be 12.7 per million population. Male to female ratio was 2.5 : 1 and the average age at injury was 35.5+15.1 (35.4+14.8 for males and 35.9+16.0 for females). The most common cause of injury was motor vehicle accidents (48.8%) followed by falls (36.5%), stab wounds (3.3%), gunshot injuries (1.9%) and injuries from diving (1.2%). One hundred and eighty-seven patients (32.18%) were tetraplegic and 394 patients (67.8%) were paraplegic. The most common level of injury was C5 among tetraplegics and T12 among paraplegics. The most prevalent associated injury was head trauma followed by extremity fractures. Severe head trauma resulting in death may obscure the real incidence of SCI and may cause underreporting of cases in epidemiological studies. Conclusion: Considering that motor vehicle accidents and falls were found to be the leading causes of traumatic SCI, it was concluded that the prevention measures should be focused mainly on these in order to reduce the frequency of SCI in Turkey. Spinal Cord (2000) 38, 697 ± 701

This study revealed that patients with lumbar disc herniation had the asymmetry and sagittalization of facet joints, and these alterations were more evident in the taller patients.

In 1994, a retrospective study of new cases of traumatic Spinal Cord Injury (SCI) was conducted in all the hospitals in Southeast Turkey: 75 new traumatic SCI were identi®ed. The estimated annual incidence was 16.9 per million population. The male/female ratio was 5.8/1. The mean age was 31.3, being 31.25 for male patients and 31.36 for female patients. 70.7% of all patients were under the age of 40. The major causes of SCI were falls (37.3%) and gunshot wounds (29.3%), followed by car accidents (25.3%), and stab wounds (1.3%). Thirty one patients (41.3%) were tetraplegic and 44 (58.7%) paraplegic. In tetraplegic patients the commonest level was C5, in those with paraplegia L1. The commonest associated injury was head trauma followed by fractures of the extremity(ies). Severe head trauma, being a major cause of death, may have obscured the actual incidence of SCI. Most of gunshot injured SCI patients were young soldiers ®ghting against the rebels. As there was no available data for the rebels with SCI, the actual incidence of SCI in Southeast (SE)Turkey should be higher than that found in this study.

Functional independence measure (FIM) is becoming widely used for all aspects of disabling diseases including spinal cord injury (SCI). It is recommended that it is rated by trained clinicians familiar with the patients. We aimed to compare the ratings of those patients who were questioned with those who were observed in a simulated environment.Fifty patients with SCI were included in the study. They were all FIM rated by the same clinician, ®rst by questioning and then by observation. Although observational rating took much more time than questioning there was a very strong correlation between these two dierent rating methods.We can conclude that questioning SCI patients could be used as a valuable and quick way to assess the functional level of such patients. Although this does not exclude observational scoring that was generally higher and more motivational for the patient.