Traumatic Spinal Cord Injury, an Overview of Epidemiology and Management in Vindhya Region
Keywords:Spinal trauma, spinal fracture, India, complications, reoperation, mortality, public versus private hospitals, spinal surgery
Background: Traumatic spinal cord injury (SCI) is a life changing neurological condition with substantial
socioeconomic implications for patients and their care-givers. Recent advances in medical management of
SCI has significantly improved diagnosis, stabilization, survival rate and well-being of SCI patients.
Objectives: The objectives of this study were (1) to determine the characteristics of patients sustaining spinal
trauma in India and (2) to explore the association between patient or injury characteristics and outcomes
after spinal trauma.
Method: The study includes patients admitted with TSCI admitted at the Central shyam shah memorial
medical college and associated government medical college, from March 2019 to March 2020. Patient
enrolled for the study were admitted directly or after being referred from peripheral health centers. Both
conservatively managed and operated patients were taken into account
Results: Most patients were middle-aged (mean age = 51.0 years; median age = 55.5 years; range = 18.0
to 72.0 years), male (60.4%), injured from falls (72.4%), and treated in a private setting (59.9%). Fractures
in the lumbar region (51.0%) were most common, followed by thoracic (30.7%) and cervical (18.2%).
More than 1 in 5 (21.6%) patients experienced a treatment delay greater than 24 hours, and 36.5% arrived
by ambulance. Thirty-day mortality and complication rates were 2.6% and 10.0%, respectively. Care in
the public hospital system (odds ratio [OR] = 6.7, 95% CI = 1.1-41.6), chest injury (OR = 11.1, 95% CI =
1.8-66.9), and surgical intervention (OR = 4.8, 95% CI = 1.2-19.6) were independent predictors of major
Conclusions: Treatment in the public health care system, increased severity of injury, and surgical
intervention were associated with increased risk of major complications following spinal trauma. The need
for a large-scale, prospective, multicenter study taking into account spinal stability and neurologic status is
feasible and warranted.
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