Patterns of Traumatic Spinal Injuries in the Developing World: A Five-Year Longitudinal Review

Abstract

Retrospective review. A 5-year longitudinal study documenting and comparing patterns of traumatic spinal injuries (TSIs) observed in developing countries. Current knowledge of the patterns and epidemiology of TSI are based on evidence from developed countries and there is a lack of data from developing countries to enable a comparison of information to formulate healthcare policies. A review of case records of all patients treated at a tertiary level trauma center over a 5-year period (2015-2019) was performed. Epidemiological, clinical, and radiological data were analyzed. The incidence of spinal trauma was 6.2% (2,065/33,072) among all trauma patients. Among these 2,065 patients, the mean age was 43.4±16.3 years and 77.3% (n=1,596) were aged 21-60 years. The major cause of injury was falls (52.1%, n=1,069) and 49.8% were high-energy falls (>10 feet). In patients with TSI due to falls, injuries occurred at the workplace (n=376), home (n=309), trees (n=151), wells (n=77), and electric poles (n=57). Road traffic accidents contributed to 42% (n=862) of TSIs and predominantly affected motorcyclists (52%, n=467). Around half (53.5%, n=1,005) of all patients were in the lower socioeconomic strata. The most common injury level was thoracic region (37.2%, n=769). Spinal cord injury (SCI) occurred in 49% (n=1,011) of patients and 49.7% (n=1,028) had injuries associated with other organs. Our study indicated different demographic patterns and epidemiological features of TSI compared with the Western literature, including a preponderance of young male patients, falls from heights, motorcycle accidents, and a larger percentage of SCI. The high number of falls at workplace indicates a lack of knowledge among the public and policy makers about safety measures.