Cervical Spine Injury: A ten-year multicenter analysis of evolution of care and risk factors for poor outcome in southeast Nigeria

Abstract

The cervical spine is the most commonly injured spinal segment in southeast Nigeria. Although treatment evolution has resulted in reduction of hospital stay, the associated mortality risk still remains high.

Clinical outcome of closed reduction of cervical spine injuries in a cohort of Nigerians

“…The mean age and the male preponderance in this series are similar to other studies on CSI [4,12,20,22,23]. One of such studies found an average age of 42 years and males accounted for 76.8% of the patients [4].…”

“…Other causes of failed reduction were: facet lock (20.3%), worsening pain (4.1%), and over-distraction (2.7%). The reported causes of failed closed traction reduction in other studies include those already cited, as well as non-contiguous vertebral fracture at a more rostral level, facet fracture at the level of subluxation, worsening neurologic deficits, cervical disc herniation, epidural haematoma, cord oedema, arm weakness, tong pull-out, inadequate immobilisation, and poor patient status (cardiac, respiratory, and haemodynamic instability) [2,4,5,8,12,14,15,17,18,22,25]. The complications of closed traction reduction seen in our series were over-distraction (7%) (Fig.…”

“…In another study, the average age was 44 years and men were twice affected than women [24]. Other studies from Nigeria found average ages of 32.6 (±1.9 years) to 40.1 (±1.1 years) [20,22,23]. Young adult males are more likely to be involved in road traffic accidents (sustaining various injuries including CSI) because they are more mobile, adventurous, and more likely to be involved in sporting activities.…”

“…The use of closed traction reduction of CSIs has been reported in various parts of Africa, with differing reported outcomes and effectiveness [18][19][20][21][22][23]. In our neurological surgery service, established in 1962, CSIs are managed mainly by closed reduction using Crutchfield's calipers (before 1988) and GWT (after 1988) traction.…”

The Management of Cervical Spine Injuries – A Literature Review

“…4 , 5 In a retrospective ten-year multicentre analysis of CSI in the southeast of Nigeria, Uche et al found a male to female distribution of 3.1:1 in the study cohort. 6 Motor vehicle accidents, fall from height, sports-related injuries and assault are the most common causes of CSI in the younger population. 7 In the elderly, non-traumatic causes of cervical spine injuries that may be due to osteoporotic compression fractures, degenerative diseases of the spine or compression fractures from spinal tumours are more prevalent.…”