Non Traumatic Spinal Cord injury in Khyber Pakhtunkhwa Pakistan; Epidemiology, Clinical Characteristics and Complications

Amir Zeb, Aatik Arsh, Sher Bahaddar, Syed Muhammad Ilyas, Shah Khalid

Abstract


Background: Spinal Cord Injury (SCI), regardless of traumatic or non-traumatic origin, is a life altering event. NTSCI is a major but under reported cause of paralysis and represent considerable proportion of SCI patients admitted to rehabilitation centers in Pakistan.  Objective: To determine the demographic information, neurological presentation, clinical features and complications of NTSCI patients in Pakistan. Material & Methods: It was cross-sectional study based on review of secondary data (medical Records) of patients with spinal cord injuries admitted at Paraplegic center from July 2011 to March 2017. All record of patients with spinal cord injuries were retrieved and reviewed thoroughly and impairment was categorized using “American Spinal Cord Injury Association (Asia) Impairment Scale”. Data were analyzed using SPSS version 20. Results: A total of 1370 SCI patients were admitted to Paraplegic Centre Peshawar, out of which 77 (5.63%) patients with mean age of 37.3±18.4 years were diagnosed with NTSCI. Out of total 77 participants, 48 (62.3%) were males and 29 (37.7%) were females. Regarding the neurological status 44 (57.1%) had incomplete SCI (ASIA B, C, D and E) while 33 (42.9%) patients were suffered from complete SCI (ASIA A). The main causes of NTSCI (in descending orders) include; postoperative paralysis 22(28.6%), degenerative Spondylosis18 (23.4%), spine tumor 10(13.0%), tuberculosis 8 (10.4%), transverse myelitis 8 (10.4%), Spina bifida 5 (6.5%), epidural abscess (45.2%) and scoliosis 2(2.6%). Secondary complication in terms of pressure ulcer was reported in 46 (59.7%). Other co-morbidities included; Deep venous thrombosis (DVT) in 2 (2.6%), bone fractures 5 (6.5%), diabetes mellitus 3 (3.9%) and hypertension 2 (2.6%). Conclusion: NTSCI patients had preventable causes, if not treated could lead to complete and incomplete SCIs, leading to pressure ulcers and DVT, diabetes myelitis and hypertension.

Keywords


Pressure ulcers, spinal cord injuries, Non traumatic injuries, epidemiological

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