Skull traction for cervical spinal injury in Enugu: A 5-year retrospective multicenter analysis of the clinical outcomes of patients treated with two common devices

Uche, EO; Nwankwo, OE; Okorie, E; Muobike, A

doi:10.4103/1119-3077.188713

Cited by 5 publications

(8 citation statements)

References 13 publications

(31 reference statements)

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“…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].…”

Section: Discussionsupporting

confidence: 89%

“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Adeolu

Ukachukwu

Adeolu

et al. 2019

Spinal Cord Ser Cases

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Study design A prospective observational study. Objectives To evaluate the effectiveness of closed reduction of cervical spine injuries (CSIs) using cervical traction and identify probable complications. Setting Methods Consecutive CSIs managed by closed reduction using Gardener-Well's Tongs traction were prospectively analysed. The data included imaging and neurological examinations findings, Frankel grading, and extent of reduction. Reduction of 95% or more was deemed satisfactory. The primary outcome measures were extent/degree of reduction and neurologic status classified as improved, same, or worse. Other complications were taken as secondary outcome measures. Result Seventy-four patients, 49 males, mean age 35.2 years (SD 9.7) were included. In all, 78.4% presented within 72 hours of injury. In total, 85.1% had road traffic crashes. Anterior subluxation was seen in 86.5%. The degree of displacement was <25% in 36/74 (48.6%), 25-50% in 19/74 (25.7%), 50-75% in 8/74 (10.8%), and >75% in 11/74 (14.9%). Traction reduction was done after 7 days of injury in 52.7% and same day of injury in 1.4%. Reduction weight ranged from 2 kg to 60 kg. Reduction was satisfactory in 67.6% and failed in 32.4%. In all, 81.1% of patients remained neurologically the same, while 18.9% improved. Causes of failed reduction were facet lock (15), old injury (8), new-onset/worsening pain (3), and over-distraction (2). Complications of closed reduction were over-distraction (5), tong pull-out (2), new-onset/worsening pain (2), and skull perforation (1). Conclusions Satisfactory closed reduction is feasible in patients with CSI and significant malalignment. The method is associated with few complications.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Adeolu

Ukachukwu

Adeolu

et al. 2019

Spinal Cord Ser Cases

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“…In Chikuda's study, the mean age of patients was 60.8±18.7 [21]. In Eo Uche's study, the Mean±SD age of patients was 40.4±1.1 [22].…”

Section: Discussionmentioning

confidence: 88%

“…Demographic data, as well as the data regarding the type of patients' transportation to hospitals, pre-hospital care given to the patients (fixation, intubation, CPR in cases with cardiac arrest, interhospital transportation, Glasgow Comma Scale (GCS) both prior and subsequent to hospital admission, type of the neurological deficit, existence and type of the SCI, type of the non-surgical intervention, weight, duration and success rate of traction procedure, methylprednisolone administration, duration of stay of patients in Intensive Care Unit (ICU), and patients' outcome on discharge based on Glasgow Outcome Scale (GOS) were extracted from the registry system. The relative and absolute frequencies of each variable were assessed using the SPSS V. 22. A secondary analysis of the association between pre-hospital measures and the non-surgical interventions with patients' outcome was also carried out using discriminant analysis.…”

Section: Methods and Materials/ Patientsmentioning

confidence: 99%

Evaluation of Pre-hospital Emergency Services, Non-Surgical Interventions, and Clinical Outcomes in Patients With Traumatic Spine

Andalib

Mohtasham-Amiri

Yousefzadeh-Chabok

et al. 2019

Iran. J. Neurosurg.

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Background and Aim:The aim of this study was to assess the pre-hospital emergency services, non-surgical interventions, and clinical outcomes in patients with traumatic spine referred to Poursina hospital in Guilan. Methods and Materials/Patients: Spine trauma registry of Poursina hospital of Rasht were used. Records of patients with traumatic spine were reviewed for pre-hospital emergency services, nonsurgical interventions, and clinical outcomes during 2015 to 2019.Results: 197 patients with traumatic spine were reviewed. 80.2% of the patients were transferred by ambulance. Pre-hospital fixation was performed in 59.4% of the patients (n=117). Pre-hospital intubation was required in 1% of patients (n=2). 4.6% of the patients had Glasgow Comma Scale (GCS) <9; 3% of them (n=6) had 9< GCS<12; and 92.4% had GCS≥13. 11.7% of the patients experienced SCI. 6.1%, 1%, 3%, 0.5%, and 1% of the patients suffered from paraplegia, paraparesis, quadriplegia, quadriparesis, hemiparesis, respectively. Surgery was performed in 89.8% of the patients. Traction was performed for 3.6% of the patients. Good recovery, moderate disabilities, severe disabilities, persistent vegetative state, and death were found in 85.8%, 2%, 5.1%, 1.5%, and 2.5% of the patients, respectively, according to Glasgow Outcome Scale. Conclusion:Most of the patients were transferred to the hospital by ambulance. Pre-hospital fixation was required in more than half of the patients. Most of the patients showed GCS≥13 and a good recovery outcome, according to GCS.

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Cervical spine fracture-dislocation in patients with ankylosing spondylitis and severe thoracic kyphosis: Application of halo vest before and during surgical management

Yang

Wang

Zhang

et al. 2021

Clinical Neurology and Neurosurgery

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Skull traction for cervical spinal injury in Enugu: A 5-year retrospective multicenter analysis of the clinical outcomes of patients treated with two common devices

Cited by 5 publications

References 13 publications

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

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

Evaluation of Pre-hospital Emergency Services, Non-Surgical Interventions, and Clinical Outcomes in Patients With Traumatic Spine

Cervical spine fracture-dislocation in patients with ankylosing spondylitis and severe thoracic kyphosis: Application of halo vest before and during surgical management

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