Correlation of outcome measures with epidemiological factors in thoracolumbar spinal trauma

Abstract

Background:The epidemiological data of a given population on spinal trauma in India is lacking. The present study was undertaken to evaluate the profile of patients with thoracolumbar fractures in a tertiary care hospital in an urban setup.Materials and Methods:Four hundred forty patients with thoracolumbar spinal injuries admitted from January 1990 to May 2000 to the All India Institute of Medical Sciences were included in the analysis. Both retrospective data retrieval and prospective data evaluation of patients were done from January 1998 to May 2000. Epidemiological factors like age, sex and type of injury, mode of transport, time of reporting and number of transfers before admission were recorded. Frankel's grading was used to assess neurological status. Functional assessment of all patients was done using the FIM™ instrument (Functional Independence Measure). Average followup was 33 months (24-41 months).Results:Of the 440 patients, females comprised 17.95% (n=79), while 82.04% (n=361) were males. As many as 40.9% (n=180) of them were in the third decade. Fall from height remained the most common cause (n=230, 52.3%). Two hundred sixty (59.1%) patients reported within 48 hours. Thirty-two (7.27%) patients had single transfer, and all 32 showed complete independence for mobility at final followup. 100 of 260 (38.5%) patients reporting within 48 hours developed pressure sores, while 114 of 142 (80.28%) patients reporting after 5 days developed pressure sores.Conclusion:The present study highlights the magnitude of the problems of our trauma-care and transport system and the difference an effective system can make in the care of spinal injury patients. There is an urgent need for epidemiological data on a larger scale to emphasize the need for a better trauma-care system and pave way for adaptation of well-established trauma-care systems from developed countries.

Thoracoscopic Anterior Reconstruction Combined with Posterior Pedicle Screw-Based Fixation in Management of Thoracolumbar Junction Fractures

“…Fall from height was the most common mode of injury in our study. This agrees with several studies 6,27,28 and contradicts others studies that reported motor vehicle accidents to be the most common. 12,26 This discrepancy may be due to the lack of safety measures for those who work at heights in our society.…”

Surgery for Spinal Trauma: Early Days at a Young Institution in a Hilly State

“…A previous study published from Delhi, India, showed that among patients with spinal injuries, 40.9% were in their third decade. 9 In our study, cervical cord involvement was seen in 28.5% cases, 32.9% involved dorsal spine, and 38.6% involved the lumbar spine. On comparing the site of involvement with age groups, lumbar involvement was seen more commonly in the younger age group.…”

Early Care following Traumatic Spinal Cord Injury (TSCI) in a Rehabilitation Centre in Bangladesh - An Analysis

“…Divanoglou et al (2010) found that in Sweden only 17% had single or more intermediate admissions, while Upendra et al (2007) showed that 72.7% in India had double or more intermediate admissions. The study by Toscano et al (1988) found 10-26% pre-hospital neurological deterioration, which is similar to the figure of 10.7% found in the current study.…”

“…The number of cases of SCI manifested as complete injury (ASIA-A) during admission were: 77% in Nigeria (Igun et al, 1999), 66.8% in India (Upendra et al, 2007), 57.8% in Pakistan (Rathore et al, 2008). Hagen et al (2010) of Norway found 41.4% of cases were complete and Divanoglou et al (2010) in Sweden found 36% complete injury.…”