Outcome of spinal cord injuries managed in a centre without modern imaging facilities

Abstract

BACKGROUND: The paucity of published reports from West Africa on the outcome of spinal cord injuries (SCI) reflects the limitations of the developing health care delivery system in this part of the world.
OBJECTIVE: To review the outcome of the spinal cord injuries managed in our centre and relate same to those of published reports. METHODS: We conducted a prospective study by utilizing astructured proforma on all SCI cases admitted to and managed in our service from April 21, 2006 to April 20, 2008. The collated data were then analyzed and compared to the literature. RESULTS: Spinal injury (neural and non-neural) was diagnosed in 62 (7.5%) of 826 total consultations in the two-year period under study. Thirty-five (56.5%) of them were <40years with fewer cases at the extremes of age, and most 47 (76%) were males. Forty-nine (79%) had neural injuries of which the majority (94%) involved the spinal cord. Treatment was nonoperative in all cases, and all those with complete cord injury remained without neurological recovery, whereas 91% of cases of incomplete injuries made varying degrees of recovery. Mortality from the cord injuries was 13 (28.3%), and all were in the cervical region. Twenty (32.3%) were followed up in the out-patient clinic for a mean period of 13.7weeks (range 1.4 – 63.4weeks) following discharge. CONCLUSION: Our findings support the reports that cases of incomplete cord injury make neurological recovery, while those of complete injury do not. Our mortality rate of 28.3% compares closely with the mortality rates from other local series.

WAJM 2009; 28(6): 376–379.

Keywords: Spinal cord, injury, outcome, Frankel scale