EPIDEMIOLOGY OF SPINAL INJURIES- A DESCRIPTIVE STUDY DR.NALLI.R.GOPINATH Assistant Professor of Orthopaedics MADRAS MEDICAL COLLEGE CHENNAI TAMILNADU INDIA PROF.NALLI.R.UVARAJ OR THO SPINE UNIT ABSTRACT NO : 35318

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 to August 2011 (1year) Type of Study : Descriptive

Materials & Methods Mode of transfer Radiological diagnosis Level of injury Neurological status based on ASIA scale Associated injuries Lethality 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

Traumatic Spinal Cord Injuries in Haryana: An Epidemiological Study Roop Singh et al Indian Journal of Community Medicine Vol. 28, No. 4 ( ) 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: /sc

RESULTS Regional distribution Level of injury Number of patients Percentage Cervical % Dorsal % Lumbar % Sacral % Mixed % Total. 313 Age distribution 4.79% 20.12% 55.91% 14.37% 1.91% Injury at home : 18% Rest were -Injured outside: working place,roads,agricultural fields, wells, etc. Place of injury

Sex ratio GenderNo. of patients.Percentage. Male % Female % Male : Female :: 2.5 : 1 Marital status Occupation The population with low socioeconomic status had a high risk for spinal injuries Educational qualification People with lower educational background were at risk of spinal injuries

Cervical level.Percentage. C11.47% C23.67% C32.20% C42.20% C57.35% C65.88% C72.94% >1 level.2.20% >2 levels.1.47% SubluxationNo. of patients C1C22 C2C34 C3C48 C4C510 C5C613 C6C76 Mode of injury No of patient s Percent-age RTA % Fall from height % Fall of heavy weight over head % Sea diving % TTA % Fall on level ground % Others % History unknown % Total. 136 Cervical spine injuries Subluxations (45 cases) Incidence of subluxations of C5C6 (13 patients) was the commonest whereas C1C2 subluxation was least Vertebral fractures (40 cases) Of vertebral fractures C5 fractures were more common The least common was C1 fracture LEVELS No. of patients

Injury No. of patients Percentage Vertebral fracture % Disc prolapse % SCIWORA % Subluxation % Posterior element fractures % Total 136 Dorsolumbar injuries 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) LEVELS No. of patients

In dorsal and lumbar spine injuries also, fall from height is the main mode of injury Dorsal injuries 66 patients (72.52%) were injured by fall from height Dorsolumbar injuries Mode of injury. No. of patients. Percentage. RTA % Fall from height % Fall of heavy weight over head % Sea diving. 0 0 TTA 0 0 Fall on level ground % Others % Total. 91 Mode of injury. No. of patients. Percentage. RTA % Fall from height % Fall of heavy weight over head % Sea diving % TTA % Others % Total. 70 Lumbar injuries Lumbar injuries : also fall from height was the main mode of injury

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 and admission N0. of patients < 2 hours 76 2 – 4 hours – 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

 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 CONCLUSION