The causes, pattern and effects of spinal injury in Singapore

Abstract

A retrospective study of all spinal injury cases admitted to the Department of Rehabilitation Medicine at the Tan Tock Seng Hospital, Singapore, between 1973 and 1984 was carried out. As this department is the only one in Singapore which manages all unstable spinal fractures, it would be reasonable to assume that the data collected over these 12 years would suffice to reflect the causes, pattern and effects of spinal injuries in Singapore. Altogether 813 cases were collected for this study, of which 83.9% (682) were males and 16.1% (131) were females. Of these, 71.1% (583) were within the productive age group of 45 and below. The most common causes of spinal injuries in Singapore were industrial accidents (34.5% or 280) and road traffic accidents (33.1% or 269). We have more cervical injuries than in the USA and Australia; 44.1% had cervical injuries, 29.6% had thoracolumbar injuries (TIO-LI), 20.8% had lumbar injuries and 0.9% had sacral injuries. 75% had neurological deficits ranging from loss of skin sensation to complete tetraplegia. Compression fracture was the most common type of fracture (42.8% or 438). Our emphasis on early admission to the Centre to ensure better chance of recovery resulted in 53.9% (438 cases) being admitted from the various hospitals within one week of injury, and this in turn helped us to discharge 72.8% (592 cases) home within three months of stay in the Centre. On discharge 82.4% (670 cases) were independent in activities of daily living and 52.4% (426 cases) were independent in ambulation. Of the 610 cases who were gainfully employed before their injuries, 53% (325) were able to return to gainful employment within one year after the onset of the accident and 17% (106) returned to work after more than a year.