Epidemiology of spinal cord injuries in Novosibirsk, Russia

The incidence of spinal cord injuries (SCI) in Novosibirsk is 29.7 per million per year. Almost all of these SCI patients (94.3%) are hospitalized to our clinic. Over the past 5 years (since 1989), a total of 196 patients with SCI were admitted. SCI were distributed as follows: cervical, 96 patients (49.0%); thoracic, 54 (27.5%); and lumbar, 46 23.5%). SCI was diagnosed using computed tomography (CT), magnetic resonance imaging (MRI), pneumomyelography, epidurography, radiography and electrophysiological methods (neuromyography, evoked potentials). All patients had a neurological deficit of varying degree; Frankel grade A, 64 patients (32.7%); B, 22 (11.2%); C, 67 (34.2%); and D, 43 (21.9%). Almost 40% (39.7%) of the patients had unstable fractures, most of them being in the cervical spine. One hundred and ninety patients were operated on, 52 within 3-4 h after trauma. Several types of operation were used: anterior decompression (106 patients); posterior decompression (64 patients); omentomyelopexia (seven patients); meningomyeloradiculolysis (13 patients). Conservative treatment ('halo' traction) was applied in six patients. No patient was made worse because of the surgery. Twenty four patients had a complete neurological recovery, 113 patients could be reclassified into a higher group (Frankel classification), and 59 patients had no neurological improvement. The overall mortality was 16.8% (13.7 postoperatively).