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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 8  |  Issue : 3  |  Page : 61-63

A hospital based cross-sectional study on clinical profile of patients with spinal cord injuries


1 Department of Orthopedics, Dhanalakshmi Srinivasan Medical College and Hospitals, Tiruchirappalli, Tamil Nadu, India
2 Department of Orthopedics, Kamineni Institute of Medical Sciences, Nalgonda, Telangana, India

Date of Submission26-Oct-2020
Date of Decision08-Nov-2020
Date of Acceptance10-Nov-2020
Date of Web Publication25-Nov-2020

Correspondence Address:
Dr. Goutham Kumar
Department of Orthopedics, Kamineni Institute of Medical Sciences, Narketpally, Nalgonda, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjhs.mjhs_19_20

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  Abstract 


Background: Correct incidence of the spinal cord injuries in India is not known. Prevention is better than cure as there is no proper cure for the spinal cord injuries. Hence, study of clinical profile of patients with spinal cord injuries is required.
Objectives: The present study was undertaken to study the clinical profile of spinal cord injuries in tertiary care hospital in rural area.
Materials and Methods: This was a hospital-based cross-sectional study conducted among 56 patients with spinal cord injuries. Detailed history, required investigations were recorded. The data was analyzed using proportions.
Results: Younger age groups from 20 to 49 were more commonly affected than older age group of 50 years and above. The most common site of spinal cord injuries was at the level of thorax (64.3%) followed by lower cervical level in 21.4% of the cases. 39.2% of the study subjects had complete spinal cord injury and 60.8% had incomplete spinal cord injury. Majority had both variety of injuries in the thoracic cord.
Conclusion: It can be concluded that spinal cord injuries are common in the younger age group, thoracic site being the most common for injury and incomplete type of injury is common.

Keywords: Quadriplegia, spinal cord compression, spinal cord injuries


How to cite this article:
Krishnamurthy G, Kumar G. A hospital based cross-sectional study on clinical profile of patients with spinal cord injuries. MRIMS J Health Sci 2020;8:61-3

How to cite this URL:
Krishnamurthy G, Kumar G. A hospital based cross-sectional study on clinical profile of patients with spinal cord injuries. MRIMS J Health Sci [serial online] 2020 [cited 2021 Jan 27];8:61-3. Available from: http://www.mrimsjournal.com/text.asp?2020/8/3/61/301480




  Introduction Top


Spinal cord injuries affect the quality of life of people. It not only affects the person on physical aspects but also have strong effect on the psychological well being of the person.[1] There has been lot of technological advances in the care of the patients with spinal cord injuries not only at the outpatient level but also at the emergency departments which are aimed at appropriate management of the cases. However, even after this, spinal cord injuries affect the person and is an important cause of morbidity and mortality among them.[2]

Trauma is the most common cause of spinal cord injuries in >10% of the trauma cases and they are the important cause of death when compared to other trauma cases.[3] Incidence of fractures of the spine vary from 16 to 64/1 lakh.[4] Road traffic accidents are the most important cause of the spina cord injuries wordlwide followed by fall from a height. Osteoporosis and fall from even a low height can cause spinal cord injuries in older people whereas in younger people the most common causes are road traffic accidents and fall from height.[5]

Spinal cord injuries epidemiological factors vary in the context of India when it is compared with the Western countries. In India, the major cause of the spinal cord injuries is fall from a height. Spinal cord injuries affect the injured persons psychology as well as the social life and also the financial life thus affecting the overall quality of life.[6] Correct incidences of the spinal cord injuries in India is not known. Prevention is better than cure as there is no proper cure for the spinal cord injuries. Hence, the study of clinical profile of patients with spinal cord injuries is required.[7]

The present study was undertaken to study the clinical profile of spinal cord injuries in tertiary care hospital in rural area.


  Materials and Methods Top


Study period

Two years from October 2016 to September 2018.

Settings

Department of Orthopedics Alayher Medical College Cochin.

Sample size

Fifty six patients with the spinal cord injuries were included in the present study.

Ethics

Ethical Committee permission from College Ethical committee was obtained. Consent from the patients was obtained by giving consent form in their local language.

After taking the careful history and clinical examination, the blood samples have been sent for complete blood picture, Random blood sugar (RBS), Serum creatinine, serum electrolytes. X-ray spine, computed tomography scan, and magnetic resonance imaging spinal were also advised. The clinical features included pain, swelling, and weakness (Motor).

Statistical analysis

The data were entered into the Microsoft Excel sheet and analyzed using proportions.


  Results Top


[Table 1] shows distribution of study subjects as per age and sex. Males (82.1%) were more than females (17.9%). Younger age groups from 20 to 49 were more commonly affected than older age group of 50 years and above.
Table 1: Distribution of study subjects as per age and sex

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[Table 2] shows injuries at different spinal cord level. The most common site of spinal cord injuries was at the level of thorax (64.3%) followed by lower cervical level in 21.4% of the cases.
Table 2: Injuries at different spinal cord level

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[Table 3] shows the distribution of study subjects as per completeness of spinal cord injuries. 39.2% of the study subjects had complete spinal cord injury and 60.8% had incomplete spinal cord injury. Majority had both variety of injuries in the thoracic cord.
Table 3: Distribution of study subjects as per completeness of spinal cord injuries

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  Discussion Top


In the present study, we found that younger age groups from 20 to 49 were more commonly affected than older age group of 50 years and above. The most common site of spinal cord injuries was at the level of thorax (64.3%) followed by lower cervical level in 21.4% of the cases. 39.2% of the study subjects had complete spinal cord injury and 60.8% had incomplete spinal cord injury. Majority had both variety of injuries in the thoracic cord.

Birua et al.[8] studied 57 patients with spinal cord injuries. Majority, i.e., 81% were male similar to the present study findings. 59.6% developed the injured due to fall from a height. Twenty–39 years of age were most commonly affected. They found that 52.63% had injury at the cervical spine level compared to present study of only 21.4%. The author found that 82.45% of the study subjects had no associated injuries.

Yusuf et al.[9] studied 133 patients with traumatic spinal cord injuries. Majority were found to be young. Road traffic injuries was the most common cause of the injury in 72.2% of the cases. Sixty-two percent of the injuries affected the cervical spinal cord whereas in the present study, we found that thoracic spinal cord was the most common site of injury. 52.6% of the cases had complete spinal injury compared to 39.2% in the present study. In the author study, 42% of the cases required surgical intervention.

Aswani Kumar et al.[10] studied 152 cases of spinal injuries and most of them were young adult males which is similar to the present study finding. 71.7% of the cases were construction workers. Majority, i.e., 61.2% had injury due to fall from height. 44.1% had cervical spine injuries compared to 21.4% in the present study.

Kafle et al.[11] observed 352 cases of spinal injuries. They found that mean age of the patients was 40 years and 31–40 years were commonly affected which is similar to the findings of the present study. Eighty-one percent affected were found to be males which is also similar to the findings of the present study. 66.7% had cervical spine injury which is more than found in the present study of 21.4%.

Debebe et al.[12] studied 84 cases of traumatic spinal cord injuries. They observed that mean age was 33 years and majority, i.e., 86% were males which is similar to the findings of the present study. Thirty-seven percent had spinal cord injuries due to collision with the motor vehicle, while 31% were injured due to fall from a height and 11% due to farming injuries.


  Conclusion Top


It can be concluded that spinal cord injuries are common in the younger age group, thoracic site being the most common for injury and incomplete type of injury is common.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Lee BB, Cripps RA, Fitzharris M, Wing PC. The global map for traumatic spinal cord injury epidemiology: Update 2011, global incidence rate. Spinal Cord 2014;52:110-6.  Back to cited text no. 1
    
2.
Hansebout RR, Kachur E. Acute Traumatic Spinal Cord Injury. Up to Date. Available from: http://www.uptodate.com/contents/acute-traumatic-spinal-cord-injury. [Last accessed on 2017 Aug 15].  Back to cited text no. 2
    
3.
Akmal M, Trivedi R, Sutcliffe J. Functional outcome in trauma patients with spinal injury. Spine (Phila Pa 1976) 2003;28:180-5.  Back to cited text no. 3
    
4.
Moradi-Lakeh M, Rasouli MR, Vaccaro AR, Saadat S, Zarei MR, Rahimi-Movaghar V. Burden of traumatic spine fractures in Tehran, Iran. BMC Public Health 2011;11:789.  Back to cited text no. 4
    
5.
Wang H, Zhang Y, Xiang Q, Wang X, Li C, Xiong H, et al. Epidemiology of traumatic spinal fractures: Experience from medical university-affiliated hospitals in Chongqing, China, 2001-2010. J Neurosurg Spine 2012;17:459-68.  Back to cited text no. 5
    
6.
Mathur N, Jain S, Kumar N, Srivastava A, Purohit N, Patni A. Spinal cord injury: Scenario in an Indian state. Spinal Cord 2015;53:349-52.  Back to cited text no. 6
    
7.
McCammon JR, Ethans K. Spinal cord injury in Manitoba: A provincial epidemiological study. J Spinal Cord Med 2011;34:6-10.  Back to cited text no. 7
    
8.
Birua GJ, Munda VS, Murmu NN. Epidemiology of spinal injury in North East India: A retrospective study. Asian J Neurosurg 2018;13:1084-6.  Back to cited text no. 8
[PUBMED]  [Full text]  
9.
Yusuf AS, Mahmud MR, Alfin DJ, Gana SI, Timothy S, Nwaribe EE, et al. Clinical characteristics and challenges of management of traumatic spinal cord injury in a trauma center of a developing country. J Neurosci Rural Pract 2019;10:393-9.  Back to cited text no. 9
    
10.
Aswani Kumar K, Subrahmanyam BV, Phanindra SV, Satish Kumar S, Harish PN, RamamohanP, et al. Demographic Pattern, Clinical Profile and Outcome of Traumatic Spinal Cord Injuries at a Tertiary care Hospital. Romanian Neurosurgery (2015) XXIX 3. Available from: http://www.roneurosurgery.eu/atdoc/1_KumarA_Demographic.pdf. [Last accessed on 2017 Jun 17].  Back to cited text no. 10
    
11.
Kafle P, Yadav DK, Poudel D. Spinal cord injury, Clinical profile and its management at tertiary care center in Nepal. J Nobel Med Coll 2019;8:16-21.  Back to cited text no. 11
    
12.
Debebe F, Woldetsadik A, Laytin AD, Azazh A, Maskalyk J. The clinical profile and acute care of patients with traumatic spinal cord injury at a tertiary care emergency center in Addis Ababa, Ethiopia. Afr J Emerg Med 2016;6:180-4.  Back to cited text no. 12
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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