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Spinal injuries in the Plateau State, Nigeria
G O Igun1, O P Obekpa, B T Ugwu
1Department of Surgery, University Teaching Hospital Jos, Plateau State, Nigeria.
Objective:
To highlight the epidemiology, management and outcome of spinal cord injuries (SCI) in the Plateau State of Nigeria.
Design:
A retrospective study involving case note analysis of all patients with SCI admitted into the hospital.
Setting:
The study was carried out at the Jos University Teaching Hospital to cover January 1984 and December, 1997.
Subjects:
Sixty eight cases of SCI were studied.
Interventions:
Patients were managed by conservative and operative interventions especially in cervical subluxations involving C5 on C6.
Main Outcome Measures:
Neurological function was assessed employing Frankel scale.
Results:
There was an increased hospital incidence for SCI between 1994 and 1997. Means age of presentation was 30 years and sex ratio M:F was 10:1. Vehicular accidents accounting for 49 per cent of SCIs and collapsed tunnels (26 per cent) were the two common causes. Fracture dislocation of the spine (unstable) occurred in 52 per cent and flexion wedge fractures (stable) in 14 per cent. Ten per cent of patients had no neural deficits at presentation, 21 per cent had partial cord lesions and 69 per cent complete cord lesions. Hospital mortality was 26 per cent. The four patients subjected to posterior spinal fusion, (Frankel A to E) including 8 other patients that were conservatively managed.
Conclusion:
Centres for spinal injuries should be established incorporating hospital wards, theatres, gymnasia, nursing units, occupational therapy units, activity centres and workshops. These centres will generate comprehensive data on morbidity and morality needed for future planning.