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Original Article

J Pak Ortho Assoc.. 2018; 30(1): 21-27


Pattern of Spine Trauma Presented to Spine Unit of Tertiary Care Hospital

Abdul Satar; Muhammad Zahid Khan; Muhammad Rafiq; Muhammad Inam; Muhammad Saeed; Muhammad Arif.

Abstract
Objective: To present pattern of spine trauma in terms of etiology, age, gender, level of injury, neurological deficit type of treatment given and complications.
Methods: This study was performed at Spine Unit, department of Orthopaedic & Spine Surgery, Hayatabad Medical Complex/ Khyber Girls Medical College, Peshawar and Aman Hospital Peshawar from June 2013 to June 2016. All patients treated for spine trauma were included in the study excluding those who denied to participate. The data was acquired from the hospital record and analyzed with the help of SPSS.
Results: Total of 326 patients were included with age ranging from 5 years to 75 years having a mean age of 32.99 + 13.49 SD. Out of the total, 240(73.6%) were male and 86 (26.4%) were female. Etiology in majority of the cases was fall from height, RTA and FAI with frequencies of 199(61%), 120(36.8%) and 7 (2.1%) respectively. Most common level of injury was thoracolumbar spine involving 260 (79.8%) cases while in 66 (20.2 %) cases Cervical Spine was injured. Neurological injury was present in 167(51.2%), out of which 76(23.3%) had complete while 91(27.9%) had incomplete neurology. Fractures were classified according to AO classification into type A, type B and type C with frequencies of 121 (37.1%), 115 (35.3%) and 90(27.6%) respectively out of 326. Posterior spinal fixation (PSF) was done in 140 (42.9%) cases and decompression along with PSF was done in 78 (23.9%). Pedicle Subtraction Osteotomy was done in 7 (2.1%) cases while 7(2.1%) patients underwent vertebral column resection. In 35 (13.2%) cases ACDF was done while in 11 (3.1%) ACCF was done. Anterior screw fixation for odontoid fracture was done in 3 (0.9%) cases. In 14 patients having cervical spine injury, posterior fixation was done while in 2 cases combine procedure was done. 44 (13.5%) patients were treated conservatively. We had dorsal tear in 5(1.5%) patients, infection in10 (3.1%), new onset neurological deterioration in 2(0.6%) patients, proximal junction kyphosis in 2(0.6%) patients and 7 (2.1%) patients had implant failure.
Conclusion: We concluded that a fall from height is a major cause of spine injuries in our set up followed by Road Traffic Accidents. Preventive measures need to be instituted to lessen the devastating outcome.

Key words: spine trauma;cervical spine injury;posterior fixation



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