EPIDEMIOLOGY OF SPINAL ABSTRACT NO : 35318

INJURIES-A DESCRIPTIVE STUDY

DR.NALLI.R.GOPINATH
Assistant Professor of Orthopaedics
MADRAS MEDICAL COLLEGE
CHENNAI
TAMILNADU
INDIA

PROF.NALLI.R.UVARAJ
ORTHO SPINE UNIT
TRAUMATIC SPINAL CORD INJURY

leads to
• life-long loss of function

• reduced quality of life &

• increased morbidity and

mortality

 Peak incidence in young adults

 TSCI remains a major problem for
society
TRAUMATIC SPINAL CORD INJURY
 Knowledge about - incidence
- prevalence
-clinical consequences
 essential for planning treatment and
programmes for TSCI patients
- in hospitals &
- in local communities

 Knowledge of mechanisms of injury is

important for prevention of SCI
Materials & Methods

• Institution : Rajiv Gandhi Government

General Hospital
• MADRAS MEDICAL COLLEGE
CHENNAI
• TAMIL NADU
• INDIA
• Period : Sept. 2011 to August 2011
(1year)
• Type of Study : Descriptive
 Materials & Methods
Analysis
The results were analysed under
following headings
• Age and sex incidence
• Socioeconomic status
• Place of injury
• Time interval
between injury and admission
• Mode of injury
• Number of transfers
• Mode of transfer
• Radiological diagnosis
• Level of injury
• Neurological status based on
ASIA scale
• Associated injuries
• Lethality
 COMPARITIVE STUDIES

Traumatic Spinal Cord Injuries in Haryana: An

Epidemiological Study

Roop Singh et al
Indian Journal of Community Medicine
Vol. 28, No. 4 (2003-10 - 2003-12)
 COMPARITIVE STUDIES

The global map for traumatic spinal cord injury

epidemiology: update 2011, global incidence
rate
LITERATURE REVIEW: 1959-Jun/30/2011
(search of Medline/Embase)

B B Lee et al
Spinal Cord advance online publication
26 February 2013; doi: 10.1038/sc.2012.158
 Place of injury
RESULTS • Injury at home : 18%
• Rest were -Injured outside: working
place,roads,agricultural fields, wells,
etc.
Regional distribution Age distribution
Level of injury Number of patients Percentage

Cervical 136
43.45%
Dorsal. 91
29.07%
Lumbar. 70
22.36%
Sacral. 7
2.23%
Mixed. 9
2.87%
Total. 313
4.79% 20.12% 55.91% 14.37% 1.91%
 Sex ratio Occupation
Gender No. of patients. Percentage.

Male 225 71.88%

Female 88 28.11%

Male : Female :: 2.5 : 1 The population with low socioeconomic status

had a high risk for spinal injuries

Marital status Educational qualification

People with lower educational background were at

risk of spinal injuries
Cervical spine injuries
Subluxations (45 cases)
Incidence of subluxations of C5C6
(13 patients) was the commonest
LEVELS
whereas C1C2 subluxation was
least

Mode of No of Vertebral fractures (40 cases)

injury patient Percent-age Of vertebral fractures C5 fractures
s were more common
RTA
The least common was C1 fracture
43 31.61%
Fall from
height. 58 42.64%
Fall of No. of patients

heavy 13 9.55% Cervical level. Percentage. Subluxation No. of

weight over
head.
C1 1.47% patients
Sea diving. C2 3.67% C1C2 2
2 1.47%
TTA C3 2.20% C2C3 4
3 2.20% C4 2.20%
Fall on level C3C4 8
ground. 6 4.41% C5 7.35%
Others. C6 5.88% C4C5 10
6 4.41%
History C7 2.94% C5C6 13
unknown. 2 1.47%
Total.
>1 level. 2.20%
C6C7 6
136 >2 levels. 1.47%
Dorsolumbar injuries
Injury No. of
patients Percentage
LEVELS
Vertebral fracture
40 29.41%
Disc prolapse
14 10.29%
SCIWORA
29 21.32%
Subluxation
45 33.08%
Posterior element
fractures 8 5.88%
Total
136 No. of patients

In Dorsal injuries the incidence of lower dorsal injuries was high (58
patients) as compared to upper and mid dorsal injuries.In lumbar
injuries L1 vertebrae was commonly injured (30 patients)
Dorsolumbar injuries
• In dorsal and lumbar spine injuries also, fall from
height is the main mode of injury
Dorsal injuries Lumbar injuries
• 66 patients (72.52%) were injured
by fall from height
Lumbar injuries : also fall from
height was the main mode of injury
Mode of injury. No. of Mode of injury. No. of
patients. Percentage. patients. Percentage.
RTA 14 15.38% RTA
21 30.00%
Fall from height. 66 72.52% Fall from
height. 40 57.14%
Fall of heavy weight 1 1.09% Fall of heavy
over head. weight over 2 2.85%
Sea diving. 0 0 head.
Sea diving.
TTA 0 0 1 1.42%
TTA
Fall on level ground. 1 1.09% 1 1.42%
Others.
Others. 9 9.89% 5 7.14%
Total.
Total. 91 70
Mode of injury

RGGGH,MMC
High falls 55%

HARYANA
45%
DEVELOPED
RTA
Low falls:
Gunshot:
Time interval : Injury - admission

The time interval between injury and first admission

into hospital ranges from 25 minutes to 9 hours with an
average of 40 minutes
Time interval between injury N0. of patients
and admission
< 2 hours 76

2 – 4 hours 123

4 – 6 hours 88

>6 hours 24
NO. OF TRANSFERS
 Introduction of Emergency Ambulance Services (Toll
free No108)
 Reduced number of Transfers
 Reduced number of Complete SCI
 CONCLUSION
 Reduce risk factors and improve prevention
strategies
 Improved Health care
 Better distribution of health care resources
 Direct transfer to specialised spinal treatment centres
to reduce complications and optimise treatment and
long-term outcomes
 Need for prospective , standardised National TSCI
Registry