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 spinetrauma 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 traumasfrom 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%) anda 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 majorityof 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 neurologicdeficit (43.4%). One hundred forty one (78.3%) patients had neurologicdeficits. Pedicle screw and rods fixation (66.7%) & anterior cervicaldiscectomy/corpectomy and fusion with plating (28.9%) were the twocommon procedures done. There greater likelihood for rotational type(Type C) fracture to cause neurologic deficit (92.3%) than eithercompression (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 ofspine 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