Spine injuries; pattern, mechanisms of injury and management outcomes among patients admitted at Muhimbili Orthopaedic Institute.

Abstract

ABSRTACT Spine injury is trauma to the cord and/or its surrounding structures including the vertebral bones, ligaments and blood vessels as a result of an externally applied mechanical force. Some etiologic factors include road traffic accident, fall, missile, assault, domestic / industrial accident and sport / recreational activity. Acute injuries of the spine and spinal cord are among the most cause of severe disability and death after trauma. Acute management includes medical agents and surgical treatment that usually includes either all or a combination of reduction, decompression, and stabilization. In our settings very little is known regarding the prevalence, age, gender, anatomical levels, mechanism of injuries and management outcomes among patient with SCI. This study have helped us to understand the pattern, mechanism, management outcomes and the burden of spine injured patients admitted at MOI, thus will help to plan on care of these patients and improve rehabilitation services. Objective: To determine patterns, mechanism of injury and management outcomes among patients with spine injuries treated at MOI. Methodology: Hospital based descriptive cross sectional study was conducted at MOI. Forty five patients with spine injuries admitted at Muhimbili Orthopedic Institute were enrolled in this study from March 2013 to February 2014. Structured questioners were used to interview the patients. Results: Forty five patients were interviewed, two patients died during the course of study. Male were 42(93.3%) and Female 3(6.7%). Male to Female ratio (14:1). With a mean age of 34.5 ± 9.4years. The most affected individuals were in the age group 26 – 45 years (68.9%). MVC were the leading cause of spine injury and it occurred in 29 patients (64.4%). The cervical spine was most affected segment of the spine (53.3%), followed by thoracic spine (28.9%) and lumber spine (17.8%). Neurological deficit was observed in 31 patients (ASIA A-D) and 14 patients had no neurological deficit, (ASIA E), compression fracture (type A) and distraction injury (type B) account 91.1% and rotational injury (type C) occurred in 8.9% of patients. Among nonsurgical treated patients, 3(30.0%) patients neurologically improved. Surgical treatment was done in twenty one patients of which, 9(42.9%) patients neurologically improved. P- value: 0.72. Conclusion Young adult males are majority of patients who sustained spine injuries follows MVC. The cervical spine was the most common level of injury with complete neurologic deficit predominating.