The Nature and Complications of Acute Traumatic Cervical Spinal Cord Injury in a University Hospital in Nigeria

Abstract

Background: Traumatic cervical spinal cord injury is one of the most devastating types of injuries. It results in varying degrees of disabilities that adversely affect patients’ quality of life. This study aims to evaluate the nature and complications of traumatic cervical spinal cord injury in Benue State University Teaching Hospital, Makurdi, Nigeria (BSUTH). Methods: A retrospective study of traumatic cervical spinal cord injury patients who presented to BSUTH from June 2012 to May 2017. Socio-demographic and clinical characteristics were extracted from hospital records and analyzed with SPSS version 21.0 (Armonk, NY: IBM Corp). Results: A total of 47 patients with traumatic cervical spinal cord injury were studied. There were 42 males (89.4%) and 5 females (10.6%). Their ages ranged from 17 to 77 years with a mean of 35±16. The common causes were road traffic accidents (n=29, 61.7%), falls from height (n=8, 17.0%) and falling objects (n=5, 10.6%). Most patients were transported to the hospital in saloon cars (n=34, 72.3%). Of these patients, 3 (6.7%) had atlanto-axial (C1–C2) injuries while 44 (93.3%) had subaxial (C3–C7) injuries. Associated injuries were identified in 48.9% of patients with head injury being the most predominant. Four cases had established pressure sores on presentation. Twelve patients (19.7%) had skull traction while the rest had orthosis. Majority of the patients had ASIA class A (n=31, 66.0%) at the time of discharge. One patient (2.1%) had no neurological deficits (ASIA class E). Complications were observed in 63.8% of the patients, with skin pressure ulcers being the most frequent (36.6% of all complications). Other complications included urinary tract infections, respiratory tract infections, depression, neurogenic pain, spasms and contractures. Conclusion: Traumatic cervical spinal cord injury predominantly affected young male patients and caused by road traffic accidents. It mostly involved the subaxial spine. Majority of patients had American Spinal Injury Association Class A injury. Pressure ulcers and urinary tract infections were the most common complications encountered