Traumatic spinal cord injuries (SCI): a study of 104 cases.

BACKGROUND: Management of spinal cord injured patients is an integral part of trauma care. There is need to congregate these patients in spinal units where dedicated experts and facilities exist for better outcome of treatment and rehabilitation. The objective of this study therefore, is to promote improved quality of care in the group of patients by highlighting the deficiencies in our setting.
METHODS: This is a retrospective study of all traumatic spinal cord injured (SCI) seen at the National Orthopaedic Hospital, Enugu over a six-year period. Information about the demographics, aetiology, level of injury, associated injuries, time of presentation, referral hospital, state of injury, duration of hospitalization, outcome of treatment were obtained from patients' records. Data were analyzed using commercially available SPSS for windows 9. Descriptive statistics are given.
RESULTS: There were 104 patients, 88 males and 16 females, giving a ratio of 5.5:1. Road traffic accident, 60 (57.7%), was the commonest aetiological factor and the cervical spine, 70 (67.3%), was most often involved. Head and neck injuries were common associated injuries, 19 (18.3%) in patients with cervical spine injury. Six (5.8%) of our patients were obtunded. Most patients, 69 (66.4%), were received from private hospitals after a mean duration of 7 days. Hospitalization ranged from 1 week-120 weeks with a mean of 11 weeks. Pressure sore was the commonest complication, 30 (28.8%). Thirty six (34.4%) of patients died mainly from respiratory failure. Most of the discharged wheel bound patients (97%) were lost to follow up.
CONCLUSION: For better outcome we re-emphasize the need to establish and congregate these patients into regional spinal units. We also suggest a social legislation, which will be fundamental to social re-integration of these SCI and other severely disabled patients.