Spinal cord injury: scenario in an Indian state.

STUDY

DESIGN

Prospective observational study.

OBJECTIVES

To find out the epidemiology and demographic factors associated with patients of traumatic spinal cord injury (SCI).

SETTING

Sawai Man Singh Medical College and Hospital, Jaipur, India.

METHODS

Consecutive SCI cases admitted from January 2000 to December 2008 were evaluated on a preformed proforma for demographic factors, epidemiological data and neurological status.

RESULTS

In 2716 cases of SCI, 1400 were cervical and 1316 thoracolumbar, with male to female ratio of 4.2:1 and 71% in the age group of 20-49 years. Around 79% patients were from rural background. About 23.3% were farmers while 22.9% were laborers. Among the causes of injury, 53% patients had a fall from height and 28% suffered from road traffic accidents. Fall of heavy object over head and back (10.7%), fall with heavy object over head (3.0%) and fall following electric shock (4.0%) were uncommon causes. Complete paralysis was found in 20.5% cervical and 23.3% in thoracic injuries. Extremity and rib fractures (10.6%) and head injuries (7.2%) were common associated injuries. About 55% cases were initially attended at non-specialized centers. Proper bladder and bowel management in early phase was lacking.

CONCLUSION

Epidemiological factors of SCI in Indian scenario are different from western countries with major cause being fall. The low socio-economic status and younger age group had a major financial, social and psychological impact as majority of the patients were the primary earning members of the family. Therefore, measures should be taken to reduce the incidence of SCI.