Patterns and presentation of surgically treated patients with spine trauma in two teaching hospitals, Addis Ababa, Ethiopia
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Date
2015-11
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Addis Ababa University
Abstract
Introduction: Acute injuries of the spine and spinal cord are among the
most causes of severe disability and death after trauma.
Objectives: To determine demographics of surgically treated spine
trauma in two spine trauma centers in Addis Ababa, Ethiopia and
determine association of neurologic deficit with the type of fracture.
Patients and methods: Hospital based retrospective study undertaken
at TASH & MCM in Addis Ababa on patients operated for spine traumas
from January 1, 2011 to December 31, 2014. One hundred eighty
patient records were investigated from both hospitals.
Results: There were 180 patients with male preponderance (77.8%) and
a mean age of 32.5 years. The most common cause of spine injury was
road traffic injury (52.8%). Thoracolumbar (36.1%) and cervical (33.3%)
spine injuries were the commonest levels to be affected. The majority
of patients (55.4%) sustained a type A fracture, 23.2% a type B fracture,
and 21.5% patients experienced a type C fracture. Three patients (1.7%)
had odontoid and hangman fractures. Thoracolumbar spine injury
accounted for the highest number of cases with complete neurologic
deficit (43.4%). One hundred forty one (78.3%) patients had neurologic
deficits. Pedicle screw and rods fixation (66.7%) & anterior cervical
discectomy/corpectomy and fusion with plating (28.9%) were the two
common procedures done. There greater likelihood for rotational type
(Type C) fracture to cause neurologic deficit (92.3%) than either
compression (Type A) (30.8) or distraction (Type B) (76.9%) fractures.
This association was statistically significant (P = 0.023, Chi2 = 17.7).
Conclusions: This study demonstrates basic epidemiologic distribution
of spine injury patients who are surgically managed at the two major neurotrauma centers. Young men were the most common victims of spine injury. As RTA is the major and avoidable cause. We were able to confirm that type of fracture according to AO classification predicts the likelihood of neurologic deficit.
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Keywords
Spine fracture, AO classification, Neurological deficit, Trauma, Spinal cord injury