Epidemiological study of thoracolumbar spine fracture patients reported to tertiary care center of Central India
Keywords:Epidemiology, Thoracolumbar spine, Central Indian region, Spinal cord injury
Background: Thoracic and lumbar spine fractures account for 90% of all spine fractures recorded. In low- and middle-income countries, spinal injuries are associated with significant disability and decreased life expectancy. Non-operatively, these injuries can be managed with a thoracolumbar orthosis or hyperextension cast. The operative management with a posterior, anterior or combined approach will offer immediate mobilization and earlier rehabilitation, providing a better environment for restoration of neurological function. Aim of the study was to find out epidemiology of patients with thoracolumbar spine fracture patients.
Methods: A cross sectional observational study was conducted in department of orthopaedics at tertiary care, teaching hospital among patients with traumatic thoracolumbar spine fractures. Epidemiological data variables were collected. In statistical analysis data from 60 patient reported was recorded and analysed.
Results: Fall from height is the leading mechanism of injury among middle aged people (30-60years) with male predominance, accounting for 58.33 percent of all spinal cord injury cases. The majority (45%) of fractures were of the burst kind, followed by compression (28.3%), and then translation/rotation (21.6%). And the most-rare of all was the distracted type (just 5%). An only 15% of patients had had a complete spinal injury, whereas the remaining 85% had sustained incomplete/ no spinal cord injury.
Conclusions: Knowledge about the burden brought on by spinal cord injury makes it clear that preventing such injuries is the backbone of care. preventive measures for high-risk individuals and early definitive response by paramedics can help reducing the load caused by these injuries.
Rajasekaran S, Kanna RM, Shetty AP. Management of thoracolumbar spine trauma. Indian J Orthop. 2015;49(1):72-82.
Peev N, Zileli M, Sharif S, Arif S, Brady Z. Indications for Nonsurgical Treatment of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations. Neurospine, 2021;18(4):713-24.
El-Khoury GY, Whitten CG. Trauma to the upper thoracic spine: anatomy, biomechanics, and unique imaging features. Am J Roentgenol. 1993;160(1):95-102.
Wood KB, Li W, Lebl DS, Ploumis A. Management of thoracolumbar spine fractures. Spine J. 2014;14(1):145-64.
Mittal S, Rana A, Ahuja K, Ifthekar S, Sarkar B, Kandwal P. Pattern of spine fracture in Sub-Himalayan region: A prospective study. J Clin Orthop Trauma. 2021;15:27-32.
Zileli M, Sharif S, Fornari M. Incidence and Epidemiology of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations. Neurospine, 2021;18(4):704-12.
Williams D. Campbell’s operative orthopedics. In Fracture, Dislocation and fracture dislocations of spine 14th ed. 2021;2:1832-923.
Khurana B, Sheehan SE, Sodickson A, Bono CM, Harris MB. Traumatic Thoracolumbar Spine Injuries: What the Spine Surgeon Wants to Know. Radio Graphics, 2013;33(7):2031-46.
Hurlbert RJ. Methylprednisolone for acute spinal cord injury: an inappropriate standard of care. J Neurosurg: Spine, 2000;93(1):1-7.
Weinstein JN, Collalto P, Lehmann TR. Thoracolumbar “Burst” Fractures Treated Conservatively: A Long-Term Follow-up. Spine, 1988;13(1):33-8.
Vaccaro AR, Kim DH, Brodke DS, Harris M, Chapman J, Schildhauer T et al. Diagnosis and management of thoracolumbar spine fractures. J Bone Joint Surg-Am. 2003;85(12):2456-70.
Singh G, Prakash R, Bhatti V, Mahen A. Spinal cord injury in organizational setup-A hospital based descriptive study. J Marine Med Society. 2019;21(1):46.
Hagen EM. Still a Need for Data from Developing Countries on Traumatic Spinal Cord Injury. Neuroepidemiology. 2013;41(2):86-7.
Chhabra HS, Arora M. Neglected traumatic spinal cord injuries: causes, consequences and outcomes in an Indian setting. Spinal Cord. 2012;51(3):238-44.
Chhabra HS, Sharma S, Arora M. Challenges in comprehensive management of spinal cord injury in India and in the Asian Spinal Cord network region: findings of a survey of experts, patients and consumers. Spinal Cord, 2012;56(1):71-7.
Birua G, Munda V, Murmu N. Epidemiology of spinal injury in North East India: A retrospective study. Asian J Neurosurg. 2018;13(04):1084-6.
Singh G, Prakash R, Bhatti V, Mahen A. Spinal cord injury in organizational setup - A hospital based descriptive study. J Marine Med Society, 2019;21(1):46.
Mathur N, Jain S, Kumar N, Srivastava A, Purohit N, Patni A. Spinal Cord Injury: Scenario in an Indian State. Spinal Cord. 2014;53(5):349-52.
Agarwal P, Upadhyay P, Raja K. A demographic profile of traumatic and non-traumatic spinal injury cases: a hospital-based study from India. Spinal Cord. 2006;45(9):597-602.
Aleem IS, DeMarco D, Drew B, Sancheti P, Shetty V, Dhillon M et al. The Burden of Spine Fractures in India. Global Spine J. 2017;7(4):325-33.
Katsuura Y, Osborn JM, Cason GW. The epidemiology of thoracolumbar trauma: A meta-analysis. J Orthop. 2016;13(4):383-8.