Pattern and Outcome of Management for Traumatic Closed Cervical Spine Injuries at The National Orthopaedic Hospital, Enugu, Nigeria

Authors

  • O N Moghalu National Orthopedic Hospital, Enugu, Nigeria.
  • G O Eyichukwu National Orthopedic Hospital, Enugu
  • U E Anyaehie National Orthopedic Hospital, Enugu, Nigeria.

DOI:

https://doi.org/10.60787/tnhj.v11i1.45

Keywords:

Cervical spine injury, Pattern, Outcome, Nigeria

Abstract

Background: The cervical spine is an area quite prone to trauma due to its mobile character. It is placed under various significant demands during various physical activities which predispose it to various injuries. The knowledge and good understanding of the common patterns of cervical spine injuries and their mechanisms will facilitate accurate assessment, diagnoses and prompt appropriate decisions about specific management. The main thrust of the application of epidemiologic methods to the study of spinal injuries is aimed at identifying injury trends and correlating these trends with definite risk factors and preventive strategies. The aim of the study is to determine the pattern and early outcome of management of closed cervical spine injuries at Enugu.

Methods: A retrospective study was done in which the records of 132 patients admitted for closed cervical spine injuries over a ten year period were analyzed and the following data extracted: demographic indices, mechanism of injury, spinal level of injury, type of vertebral injury, complications, duration of stay in hospital, nature and level of cord injury, residual morbidity at discharge, and duration of follow-up visits.

Results: The age of the patients ranged from 5 - 80 years with a mean of 37 years. More males were involved (93.9%) than females (6.1%). The commonest mechanism of injury is road traffic accidents (66.7%) and the most frequently involved segment is the C6/C7. Fracture subluxation of C6 on C7 occurred in 27.3% of cases. 75.8% of cases had complete cord injury while 24.2% had incomplete lesions. Pressure sores and urinary tract infection were the commonest complications seen in 29.5% and 24.4% respectively. The length of hospital stay for the majority of the patients (47%) was between 4 weeks and 12 weeks. At discharge, 56% of all the patients were wheel chair bound, 22.7% were mobilizing with walking aids and death occurred in 21.2%, mostly high cervical cord injured patients. 93.6% of the patients with incomplete cord injury were mobilizing with walking aids at the point of discharge. 60% and 75% of the patients were lost to fellow- up at one and two years respectively.

Conclusion: Lower cervical spine fracture subluxation is the commonest site of cervical spine injury in our environment. Complete cord injury is commoner than incomplete cord injury. The commonest complications in our environment are pressure sores and urinary tract infection. Prevention of these injuries remains the best management option.

Downloads

Download data is not yet available.

References

Torg JS, Sennett B, Vegso JJ, Pavlov H: Axial loading injuries to the middle cervical spine segment, Am J Sports Med. 1991;19(1): 6-20.

Allen BL jr., Ferguson RL, Lehmann TR, O'Brien RP: A mechanistic classification of closed, indirect fractures and dislocations of the lower cervical spine. Spine. 1982; 7:1-27.

Denis F: Spinal instability as defined by the three-column concept in acute spinal trauma. Clin Orthop Rel Res 1984; 189: 65-76.

Ducker TB; Bellegarrigue R, Salcman M, Walleck C: Timing of operative care in cervical spine cord injury. Spine. 1984; 9: 525 531.

Pang D, Wilberger JE jr: Spinal cord injury without radiological abnormality in children. J Neurosurg. 1982; 57:114.

Osonback RR, Menezes AH: Paediatric Spinal cord and vertical column injury. Neurosurgery 1992; 30(3): 385.

American college of Surgeons: Advanced Trauma Life Support Course for Physicians, Chicago 1989. American college of Surgeons.

Chestnut RM, Marshall LF: Early assessment, transport and management of patients with post traumatic instability. In Cooper PR (ed.): Neurosurgical topics: Management of post traumatic spinal instability, Park Ridge, Illinois, 1990, American Association ofNeurosurgical Surgeons.

Bracken MB, Shephard MJ, Collens WF: A randomized controlled trial of methyl prednisolone or naloxon in the treatment of acute spinal cord injury, N Engl J Med. 1990; 322: 1409.

Bohlman HH, Complications of treatment of fractures and dislocations of the cervical spine. In Epps CH (ed.): ndComplications in Orthopedic Surgery, 2 ed., 897-918, Philadelphia, JB Lippincott, 1985.

Gerndt SJ, Rodriquez JL, Pawlik JW, Taheri PA, Wahl WL, Michael AJ, Papadopoulos SM: Consequences ofhigh dose steroids therapy for acute spinal cord injury. J. Trauma 1997; 42; 279-284.

Geisler FH, Dorsey FC, Coleman WP: Recovery ofmotor function after spinal cord injury a randomized placebo-controlled clinical trial with GM-1 ganglioside, N Engl J Med. 1991; 324(26):1829 1832.

Hugenholtz H, Cass DE, Dvorak MF, Fewer DH, Fox RJ, Izukawa DM: High dose methyl prednisolone for acute closed spinal injury only a treatment option. Can. J Neurol Sci 2002; 29: 227-35.

Murthy TVSP: Management of spinal cord injury; issues of debate. IJNT 2007, 4(1): 15 -19.

University of Rochester Medical Center (2008 September 19). Key advance in treating spinal cord injury found in manipulating stem cells. Science daily. Retrieved may 16, 2010, from http://www.science daily.com/releases/2008/09/080918192939.htm

Nwadinigwe CU, Iloabuchi TC, Nwabude IA. Traumatic Spinal Cord Injuries (SCI): a study of 104 cases. Niger J Med 2004 13(2): 161-165

Solagberu BA. Spinal Cord injuries in Ilorin, Nigeria. West Afr Med 2002; 21: 230 - 232

Umaru H, Ahidjo A. Pattern of Spinal Cord Injury in Maiduguri, North Eastern Nigeria. Niger J Med 2005 14(3): 276-278

Eze CB. A ten week programme for the hospital management of acute traumatic paraplegia and quadriplegia. Orient journal of medicine 1992; 4(4): 93 95.

Nwankwo OE, Katchy AU: Outcome of a 12-week programme for management of the spinal cord injured with participation of patients relations at Hilltop Orthopaedic Hospital, Enugu, Nigeria. Spinal cord 2003, 41, 129 133

Goldberg W, Mueller C, Panacek E, Tigges S, Hoffman JR, Mower WR: Distribution and patterns of blunt traumatic cervical spine injury. Ann Emerg Med. July 2001, 38: 17-21.

Hasue M, Hoshino R, Omata S: Cervical spine injuries in Children. Fukushima J Med Sci 1971; 20, 111- 113

Henrys P, Lyne ED, Lifton C, Salciccioli G: Clinical review of cervical spine injuries in Children. Clin Orthop, 1997; 129.

Richard EB, Ronald FM, Fredrick M, Rosalie K. Incidence, Characteristics, and Outcome of spinal cord injury at trauma centers in North America. Arch Surg. 1993; 128(5): 778 - 781.

Udosen AM, Ikpeme AI, Ngim NE. A prospective study of spinal cord injury in the University of Calabar The Nigerian Health Journal, Vol. 11, No 1, January - March 2011Page 31Eyichukwu G.O, et al - Closed Cervical Spine InjuriesNigeria: A preliminary Report. The Internet Journal of Orthopaedic Surgery. 2007; 5(1): 344-347.

Downloads

Published

2015-12-02

How to Cite

Moghalu, O. N., Eyichukwu, G. O., & Anyaehie, U. E. (2015). Pattern and Outcome of Management for Traumatic Closed Cervical Spine Injuries at The National Orthopaedic Hospital, Enugu, Nigeria. The Nigerian Health Journal, 11(1), 27. https://doi.org/10.60787/tnhj.v11i1.45
Abtract Views | PDF Download | EPUB Download: 718 / 59

Similar Articles

<< < 4 5 6 7 8 9 10 11 12 13 > >> 

You may also start an advanced similarity search for this article.