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[Spine surgery in a combat support hospital].
C Schulz1, U Kunz2, U M Mauer2
1Abt. Neurochirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland. chris.schulz@extern.uni-ulm.de.
Der Orthopade
|December 5, 2015
Summary
This study analyzed 7 years of spinal surgery in Afghanistan, finding a high rate of degenerative conditions and elective procedures, particularly among Afghan civilians. The changing pattern of spine-related diagnoses presents challenges for future mission planning.
Area of Science:
- Neurosurgery
- Combat Medicine
- Spinal Surgery
Background:
- Neurosurgical services were continuously available at a multinational Role 3 combat support hospital in Mazar-e-Sharif (MeS), Afghanistan, from July 2007 to October 2014.
- This paper analyzes a 7-year experience of operative and outpatient spinal surgery caseloads.
Purpose of the Study:
- To analyze the operative and outpatient spinal surgery caseload experience over a 7-year period.
- To differentiate surgical cases by indication strength, surgical site location, and patient origin.
- To analyze the outpatient caseload and spectrum for the years 2012 and 2013.
Main Methods:
- Determined overall annual and monthly caseloads.
- Differentiated surgical cases by indication strength, surgical site location, and patient origin.
- Analyzed outpatient caseload and spectrum for 2012-2013.
Main Results:
- A total of 341 surgeries were performed, with 188 (55.1%) being spinal surgeries.
- Degenerative diseases constituted the majority of spinal surgeries (127/188; 67.6%), while fractures and penetrating injuries increased over time (61/188; 32.4%).
- 80% of immediate/urgent surgeries were for fractures/penetrating injuries; 19.8% of surgeries were emergencies, 17.3% delayed urgency, and 62.9% elective. 82% of 1026 outpatient consultations were for spinal diseases.
Conclusions:
- The MeS caseload and case distribution were lower than other ISAF nations, with a higher rate of elective surgeries and procedures on civilian Afghan patients.
- MeS showed a unique concentration of degenerative spinal conditions compared to other ISAF military hospitals.
- The evolving pattern of spine-related diagnoses and surgical treatments in conflict zones poses challenges for future educational and material planning.
