Surgical management of traumatic spinal injuries in Sylvanus Olympio Teaching Hospital

Résumé

Abstract Introduction : Traumatic spinal injuries (TSI) is a global disease burden in low - and middle–income countries (LMIC). The burden of TSI is higher in LMICs than in developed countries. Despite improvements in TSI management, resource-constrained settings have not benefitted from this progress to the same extent as more developed countries. Hypothese : Spinal implants availability and early surgery are associated with improved neurologic function.Material and methods: This is a retrospective and descriptive study from November 2017 to October 2020. We included adult patients who presented with traumatic spine injury and who underwent surgery stabilization.Results: A total of 93 patients were studied. The population was young (35.92 ± 9.68 years old), men (91.4%). Road traffic accidents accounted for 85% of patients. At presentation, 59.1% of patients had an incomplete neurologic deficit (ASIA B-D). The cervical spine was the most common segment injured (57%). The median time from admission to the operating room was 21.06 ± 11.8 days. After surgery, 15.3% improved by at least 1 ASIA grade. Bedsores (14%) and superficial wound infection (10.8%) were the most typical complications in our series after surgery. Discussion : According to the AANS/CNS guideline, available literature has defined « early » surgery inconsistently, ranging from < 8 hours to < 72 hours. In our series, the median time from admission to the operating room was 21.06 ± 11.8 days (range 2-62). That finding could be explained by the fact that most low-income people have to pay out of their pocket because the rate of medical insurance coverage is low. In the study, only 17.2% of patients have public insurance, and 2.2% private insurance. We performed three types of surgery: anterior cervical discectomy and fusion, anterior cervical corporectomy with tricortical iliac crest graft and plate, and posterolateral thoracic/lumbar fusion. Implant availability for posterior cervical fusion was the principal driver of that decision in our limited resources.Type of study and level of proff: level 3, retrospective cohort study.

Citer ce document

Accès au document

Ce document est hébergé sur son dépôt institutionnel d'origine.

Auteur(s)

Statistiques

Consultations : 1

Téléchargements : 0