Outcome in patients undergoing surgery for spinal injury in an Ethiopian hospital

Abstract

<jats:sec> <jats:title>OBJECT</jats:title> <jats:p>The objective of this study was to investigate epidemiology and outcome after surgical treatment for spinal injuries in Ethiopia.</jats:p></jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>Medical records of patients who underwent surgery for spine injuries at Myungsung Christian Medical Center in Addis Ababa, Ethiopia, between January 2008 and September 2012 were reviewed retrospectively. Assessment of outcome and complications was determined from patient consultations and phone interviews.</jats:p></jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>A total of 146 patients were included (129 males, 17 females). Their mean age was 31.7 years (range 15–81 years). The leading cause of injury was motor vehicle accidents (54.1%), and this was followed by falls (26.7%). The most common injury sites were lumbar (41.1%) and cervical (34.2%) regions of the spine. In 21.2% of patients, no neurological deficit was present before surgery, 46.6% had incomplete spinal cord injury (American Spinal Injury Association [ASIA] Impairment Scale [AIS] Grade B-D), and 32.2% had complete spinal cord injury (AIS Grade A). Follow-up was hampered by suboptimal infrastructure, but information regarding outcome was successfully obtained for 110 patients (75.3%). At follow-up (mean 22.9 months; range 2–57 months), 25 patients (17.1%) were confirmed dead and 85 patients (58.2%) were alive; 49 patients (33.6%) underwent physical examination. At least 8 of the 47 patients (17.0%) with a complete injury and 29 of the 68 patients (42.6%) with an incomplete injury showed neurological improvement. The reported incidences of pressure wounds, recurrent urinary tract infections, pneumonia, and thromboembolic events were 22.5%, 13.5%, 5.6%, and 1.1%, respectively.</jats:p></jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>Patients showed surprisingly good recovery considering the limited resources. Surgical treatment for spine injuries in Ethiopia is considered beneficial.</jats:p></jats:sec>

Long-Term Systematic Outcome Assessment of Patients Following Spine Surgery in Rwanda: The Use of Patient Reported Outcome Tools

“…Demographics: The distribution of age and sex showed a substantially young population and male predominance in the trauma group; similar to what is found in other African spinal cord injury studies [9,10]. ii.…”

“…Furthermore, some of these traumatic spinal cord injuries are associated with high rate of mortality when treated non-operatively [9,10,15].…”

Epidemiology and Clinical Management of Traumatic Spine Injuries at a Major Government Hospital in Cambodia

“…Preadmission deaths may also explain why we did not observe any injuries at the atlantoaxial complex, which can compromise the brainstem leading to cardiorespiratory demise. Furthermore, given that 56% (45/80) of our patients were lost to follow-up, it is possible that some of our patients may have died following discharge; a study in Ethiopia with 23 month average follow-up revealed that 17% of patients who underwent surgery for spine fractures died, all after discharge [ 4 ]. Efforts to improve patient follow-up through family members may help clarify this concern in the future.…”

“…Traumatic spine injuries (TSIs) and spinal cord injuries (SCIs) are serious global public health problems with significant financial and emotional burdens on the patients and their families [ 1 2 3 ]. Although the epidemiology of SCIs has been described in several low-and-middle-income countries (LMICs) such as Pakistan, Nigeria, and Ethiopia, little is still known about the current state of clinical management of TSIs and SCIs in these regions of lower economic status [ 4 5 6 7 8 9 10 ].…”

Epidemiology of worldwide spinal cord injury: a literature review

“…As for nondeveloped countries, the ratio varied from 1.00:1 26 to 7.59:1. 29 The mean age of SCI in developed countries ranged from 14.6 30 to 67.6 31 years. With regard to nondeveloped countries, the average age in articles varied from 29.5 32 to 46.0 33 years.…”