An epidemiological study from a tertiary care hospital in Asian subcontinent on Traumatic cervical injuries: How is the injury pattern and what are the implications?
Volume 1 | Issue 2 | Sep – Dec 2016 | Page 44-48 | Dhiraj Vithal Sonawane, Ganesh Yeotiwad, Ajay Chandanwale, Swapnil Keny, Abhijeet Salunke, Ambarish Mathesul, Eknath Pawar
Authors : Dhiraj Vithal Sonawane [1], Ganesh Yeotiwad [1], Ajay Chandanwale [3], Swapnil Keny [1], Abhijeet Salunke [4], Ambarish Mathesul [3], Eknath Pawar [2]
[1] Department of Orthopaedics, Grant Medical college, & Gokuldas Tejpal Hospital, Mumbai
[2] Department Of Orthopaedics, Grant medical college, Mumbai.
[3] Sasoon Hospital & BJMC, Pune
[4] Gujarat Cancer Research Institute
Address of Correspondence
Dr. Dhiraj V. Sonawane
Grant Medical college, & Gokuldas
Tejpal Hospital, Mumbai
Email: dvsortho@gmail.com
Abstract
Objective: The aim of the current study was to document the demographic pattern, mode of injury, level of cervical spine injury in patients so that it can be extrapolated for formulating guidelines in developing nations for proper management of this life threatening injury.
Methods: This study comprised of 275 patients of cervical spine injury admitted in a tertiary care centre from January 2006 to October 2015.
Results: The mean age was (3 to 95) and male to female ratio was 11.5: 1. Majority (30 %) of cases were of third and fourth decade. 60 % of patient fall from height as mechanism of injury. The urban to rural ratio of patients was 3:1 and 184 patients (67%) belonged to the rural areas. The most common mode of injury in the present study was fall from height, 166 cases (60%) of which most of them occurred while working and fall from tree. Dislocation at C 5-6 vertebral level was commonest and a C 5 vertebra was most commonly fractured. Incomplete cord injury of ASIA grade C scale was the commonest pattern seen in 156 cases. Head injury was commonest associated injury with cervical spine injury.
Conclusion: Identification of demographic data and mechanism of injury pattern helps to identify the preventable risk factors for controlling them. Proper education and training of paramedical staff in rural areas of initial aid and transportation of patients having spinal cord injuries can reduce the frequency and morbidity of spine injuries
Keywords: Cervical spine, Injury, Epidemiology, demographic study, Spinal cord, Mechanism of injury
References
1. David O`Brien. Immediate management of spinal injury In: Jones D.
Palmar (compiler) manual of neurosurgery. First edition, UK,
Churchill, Livingston. 1996; 696-708
2. George W. Wood II, Campbell’s Operative Orthopaedics, 11th ed., vol
1, Elsevier, Philadelphia; 1761-1849.
3. Sinha DK. Manual of Patna Model for the care of Spinal cord injury
patients. Patna: Sparsh. 2000; 9-13.
4. Roopsingh et al. Traumatic spinal cord injuries in Haryana: An
Epidemiological study.Indian Journal of Community Medicine Vol.
XXVIII, No.4, Oct.-Dec., 2003.
5. Gunby I. New focus on spinal cord injury.JAMA.1981;245:1201–1206.
6. Botterell EH, Jousse AT, Kraus AS et al.A model for the future care of
acute spinal cord injuries.Can J NeurolSci. 1975; 2:361-80 .
7. Kraus JF. Injury to the head and spinal cord: The epidemiological
relevance of the medical literature published from 1960 to 1978.J
Neurosurg. 1980; S: S3-10.
8. Burney R.E. et al. Incidence ,Characteristicsand Outcome of Spinal
Cord Injury at Trauma Centers in North America .Arch Surg. 1993;
128 (5):p.596-9.
9. Fife D.andJ.Kraus .Anatomic Location of Spinal Cord Injury:
Relationship to the cause of injury. Spine. 1986; 11 (1):p.2-5.
10. Riggins R.S.and J.F.Kraus. The Risk of Neurologic Damage with
Fractures to the Vertebrae.The Journal of Trauma. 1977; 17 (2): p.
126-133.
11. Miller T.R.,et al. Costs of Head and Neck Injury and a Benefit –Cost.
12. Allen B.L. et al. A Mechanistic Classification of Closed,Indirect
Fractures and Dislocation of the Lower Cervical Spine. 1982;
7(1):p.1-27.
13. Burke D.C., H.T.Burleyand G.H.Ungar. Data on Spinal Injuries –Part
1.Collection and Analysis of 352 Consecutive Admissions
.AustrN.Z.Surg. 1985; 55:p.3-12.
14. Torg J.S., et al. National Football Head and Neck Injury Registry:
Report on Cervical Quadriplegia .AM J Sports Med. 1979;
7 (2):p.127-32.
15. Annamalai K, Chinnathambi R. Spinal cord injuires -The challenges
and the achievements. Chennai: Dept.of Orthopaedic Surgery,
Govt. General Hospital,Chennai.1998; 1-50.
16. Karacan I, Koyuncu H, Pekel O, Sumbuloglu G, KirnapM, Dursum
H et al. Traumatic spinal cord injuries inTurkey: a nationwide
epidemiological study. Spina Cord. 2000; 38(11): 697-701.
17. Hu R, Mustard CA, Burns C. Epidemiology of incident spinal
fracture in a complete population.Spine.1996; 21:492-499.
18. Chacko V, Joseph B, Mohanty SP, Jacob T. Management of spinal
cord injury in a general hospital in rural India. Paraplegia.1996; 24:
330-5.
19. A psychological study of spinal cord injured patients involved in the
Madras Paraplegia ProjectO Somasundaram, S Balakrishnan, O S
Ravindran, T K Shanmugasundaram.
20. Shingu H, Ikata T, Katoh S, Akatsu T. Spinal cord injuries in Japan:
A natiowide epidemiological survey in 1990. Paraplegia 1994;
32(1): 3-8.
21. Lan C, Lai JS, Chang KH, Kan YC, Lein In. Traumatic spinal cord
injuries in the rural region of Taiwan: an epidemiological study in
Hualien Country, 1986-1990. Paraplegia 1993; 31(6): 398-403.
22. Dave PK, Jayaswal A, Kotwal PP. Spinal cord injuries -A clinicoepidemiological
study. Ind J Orthop 2002; 28: 39- 45.
23. Singh M et al. Spine injuries in a tertiary health care hospital in
Jammu: A Clinico – Epidemiological Study. The Internet Journal of
Neurosurgery.
24. Shrestha D, Garg M, Singh GK, Singh MP, Sharma Uk.Cervical
spine injuries in a teaching hospital of eastern region of Nepal; A
clinic-epidemiological study. J Nepal med Assoc 2007; 46(167):
107-111.
25. Hadley MN, Zabramski JM, Browner CM, et al. Pediatric spinal
trauma:review of 122 cases of spinal cord and vertebral column
injuries. J Neurosurg.1988;68:18–24.
26. Carreon LY, Glassman SD, Campbell MJ. Pediatric spinefractures:
a review of 137 hospital admissions. J Spinal DisordTech.2004;
17:477–482.
27. Parisini P, Di Silvestre M, Greggi T. Treatment of spinal fractures in
children and adolescents: long-term results in 44patients. Spine.
2004; 27:1989–1994. Thesleff T, 28)Niskakangas T, Luoto TM,
Öhman J, Ronkainen A. Fatal cervical spine injuries: a Finnish
nationwide register-based epidemiologic study on data from 1987
to 2010. Spine J. 2015 Dec 7. pii: S1529-9430(15)01761-1.
29. Fredø HL, Rizvi SAM, Lied B, Rønning P, Helseth E. The
epidemiology of traumatic cervical spine fractures: a prospective
population study from Norway.Scandinavian Journal of Trauma,
Resuscitation and Emergency Medicine. 2012;20:85.
30. Hasler RM, Exadaktylos AK, Bouamra O, Benneker LM, Clancy M,
Sieber R, Zimmermann H, Lecky F. Epidemiology and predictors of
cervical spine injury in adult major trauma patients: a multicenter
cohort study. J Trauma Acute Care Surg. 2012 Apr;72(4):975-81.
31. Rahimi-Movaghar V, Sayyah M, K, Akbari H, Khorramirouz R,
Rasouli M, R, Moradi-Lakeh M, Shokraneh F, Vaccaro A, R,
Epidemiology of Traumatic Spinal Cord Injury in Developing
Countries: A Systematic Review. Neuroepidemiology 2013;41:65-
85
32. Sidong Yang, Wenyuan Ding, Dalong Yang, Tixin Gu, Feng Zhang,
Di Zhang, Yapeng Sun, Lei Ma, Yanli Song.Epidemiology and Risk
Factors of Cervical Spine Injury during Heating Season in the
Patients with Cervical Trauma: A Cross-Sectional Study PLoS One.
2013; 8(11): e78358.
| How to Cite this Article: Sonawane D V, Yeotiwad G, Chandanwale A, Keny S, Salunke A, Mathesul A, Pawar E.An epidemiological study from a tertiary care hospital in Asian subcontinent on Traumatic cervical injuries: How is the injury pattern and what are the implications?. International Journal of Spine Sep-Dec 2016; 1(2): 44-48. |
