Pattern of spine fracture in Sub-Himalayan region: A prospective study

Abstract

Background: Though spine trauma contributes to great functional, psychological, and economic loss, research regarding the demographic profile of patients according to different regions of our country are lacking.This study aims to identify the demographic pattern and clinical profile of patients with spinal fracture in the Sub-Himalayan region. Method: Patients with acute or subacute spine trauma presenting within 8weeks and involving fracture of cervical, dorsal, or lumbar vertebra, from July 2017 to December 2019 were included prospectively. Patients with osteoporotic or metastatic collapse, isolated transverse or spinous process fracture, penetrating trauma or ballistic injuries were excluded. Results: Out of 280 enrolled patients, 180 were males and 100 were females. The maximum number of spine trauma patients was in 16e30 years age group. The most common mechanism of injury was fall from height (FFH, 42.5%)> road traffic accident (RTA, 38.6%). RTA was more common among males and FFH among females (p < 0.0001). Most common location of injury was at thoracolumbar junction (D10-L2) (37.5%) followed by cervical spine (25.3%). 58.2% of patients had AO type A facture morphology followed by AO types C (36.1%) and AO type B (5.7%). Spinal Cord Injury (SCI) was seen in 82.1% spine trauma patients with statistically significant association with male gender (p-0.045). Complete paralysis was seen maximum in patients with cervical spine injury (67.3%, p < 0.0001). Complete neurological deficit (ASIA grade A) was seen maximum in AO type C fracture morphology (74.25%, p < 0.001) followed by AO type A4 (29.6%). Seasonal distribution showed increased incidence during summer and monsoon season. Conclusion: Young aged males in age group of 16e30 yrs were most commonly affected with fall from height as the most common mechanism of trauma. Association was found between gender and mechanism of injury (RTA in males and FFH in females). Most common vertebral injury level was thoracolumbar junction. AO type A was the most common fracture morphology. SCI seen in 82.1% of spine trauma. Statistically significant association was found between Complete SCI with Location of Injury (Cervical) and Fracture morphology (AO type C).

Epidemiological study of thoracolumbar spine fracture patients reported to tertiary care center of Central India

“…In metropolitan regions and industrialised nations, cervical spine injuries are more prevalent as a result of traffic accidents. 5 The 23.33% patient showed neurological involvement of all thoracolumbar fracture patients. spinal cord injury reported in our study is lower as compared to other studies Agarwal et al with SCI at 66.67%.…”

“…16,[18][19][20] Patients experiencing spine trauma most often sustained injuries to the thoracolumbar spine, next by the cervical spine. 5 Despite the fact that the cervical spine has been identified as the most frequent site in prior studies. 16,18 It's possible that this finding is the result of occupational variations between rural, hilly, urban, and semi-urban locations.…”

“…3,4 In low-and middle income countries, spinal injuries are associated with significant disability and decreased life expectancy, due to their significant effect on quality of life with neurological deficit, pain, and deformity. 5,6 Thoracolumbar spine fractures account for 90% of all spine fractures recorded. 2 Such injuries are very common among young people, between 20 and 40 years old, and the most common causes of such spine trauma are motor vehicle accidents, falls, and gunshot injuries.…”

Epidemiology of Traumatic Spinal Cord Injury in the Himalayan Range and Sub-Himalayan region: A Retrospective Hospital Data-Based Study

“…Falls were a more common cause of TSCI than RTAs in this study. In contrast to affluent countries where RTAs were the most common cause, Falls were the most common mode of injury in most Indians [ 22 , 27 , 28 ] and southern Asian research [ 29 , 30 ]. More specifically, Falls were widespread in urban and rural parts of the hilly region.…”

Outcomes of Anterior Decompression and Anterior Instrumentation in Thoracolumbar Burst Fractures—A Prospective Observational Study With Mid-Term Follow-up

“…With urbanization, the incidence of spine trauma is on the rise which accounts for a great social and economic burden on patients and their families. 1 Thoracic and lumbar spine injuries account for about 90% of spinal trauma. 2 Thoracolumbar region (T11-L2) is the most common region affected because of transition from the stiff and kyphotic thoracic spine to mobile and lordotic lumbar spine.…”