Outcome of conservative treatment of spinal cord injuries in Lagos, Nigeria

Abstract

Background: The major cause of spinal cord injuries (SCI) is motor vehicular accident (MVA). Most centres still manage all their spinal cord injured patients conservatively.

Objective: The aim of this study is to examine the aetiology of SCI in Lagos; pattern of presentation and the outcome of conservative treatment.

Methods: Age, sex, cause of injury, pattern of SCI, neurologic status and eventual outcome of patients treated conservatively for SCI from 2000 to 2007 were retrospectively studied from case notes. Data were analyzed using SPSS 15.0

Results: There were 372 patients with SCI, 299 (80.4%) males and 73(19.6%) females showing a male to female ratio of 4.1:1 with mean age of 36.9±12.3 yrs over the 8-year period. Three hundred and eighteen patients (85.8%) involved road traffic injury (RTI) and 278 (74.7%) of the patients with cervical spine involvement. Incomplete neurologic deficit was noted in 245(65.1%) patients. Eighty-five (22.8%) patients died during the review interval. Frankel's grading improved in 10 (2.6%) patients with tetraplegia at least 3 levels at discharge. The mean hospitalization duration was 92.6±18.4 (range 1- 482 days).

Conclusion: SCI has emerged as a significant cause of morbidity and mortality in Nigeria. The patients are mostly male adult, sustaining injury following MVA. The cervical spine was the most common level of injury with incomplete neurologic deficit predominating. Neurologic outcome was satisfactory in a high number of the patients with incomplete injury.

Keywords: Spinal Cord Injury (SCI), Paraplegia, Tetraplegia, Frankel.