Profile of Traumatic Cervical Spine Injuries in Assiut University Hospital

Abstract Background Data: Cervical spine fractures and dislocations are potentially devastating injuries that must be quickly identified and properly managed to optimize patients’ outcomes; however, the incidence of cervical spine injuries (CSI) in Egypt is largely unknown. Purpose: To evaluate the demographics, mechanisms of injury, neurological status, and management of CSI in the Trauma Unit of Assiut University Hospital. Study Design: A retrospective descriptive analytic cross-sectional study. Patient and Methods: During the period from January 2015 to December 2016, data of all CSI patients who presented to and managed in the Assiut University Hospital Trauma Unit were retrospectively recorded. Initial management was made according to ATLS guidelines. Classification of CSI and neurological examination were conducted according to the AO classification and Frankel classification, respectively. The study was approved by our Institutional Ethical Committee. Results: During the study period, 267 patients presented with CSI and managed in Assiut University Hospital Trauma Unit. CSI occurred in approximately 1% of all admitted patients (28548 patients) during the same period, 1.3% of admitted orthopedic patients (20556 patients), and 15.5% of patients with all spinal injuries (1717 patients). Most of the patients were males (85.8%), and the most common age group was from 20 to < 40 years (39.0%). The most common causes of CSI were road traffic accidents (62.2%), falling injuries (32.6%), and heavy object trauma (5.2%). Out of 267 patients with CSI, 159 (59.5%) had neurological insults and 77 (28.8%) complete quadriplegia. Traumatic cervical disc prolapse occurred in 63 patients (23.6%), upper CSI in 23 patients (16.1%), and subaxial cervical fracture type A in 24 patients (15.7%), type B in 32 patients (12%), and type C in 87 patients (32.6%). The preoperative in-hospital mortality rate was 14.6% (39 patients). Conclusion: In our locality, the most common cause of CSI was road traffic accidents, which mainly involved young people in the most productive age group, leading to a high rate of disability and mortality. Preventive measures in roads and proper use of protective equipment in vehicles must be practiced avoiding such major consequences for individuals, families, societies, and economic resources. (2020ESJ210)   Background: Cervical spine fractures and dislocations are potentially devastating injuries that must be quickly identified and properly managed in order to optimize patients’ outcomes, although its incidence is largely unknown. Purpose: To evaluate the demographics, mechanisms of injury, neurological status and management of cervical spine injuries (CSI) in the trauma Unit of Assiut University Hospital. Study Design: A descriptive analytic cross section study. Patient and Methods: During the period from January 2015 to December 2016, data of all CSI patients who presented to and managed in Assiut University Hospital Trauma Unit were prospectively recorded. Initial management was made according to ATLS guidelines. Classification of cervical spine injuries was made according to the AO classification and neurological examination was made according to Frankel classification. The study was approved by our Institution Ethical Committee. Results: During the study period, 267 patients presented with CSI and managed in Assiut University Hospital Trauma Unit. CSI represented about 1% of all admitted patients (28548 patients) during the same period, 1.3% of admitted orthopedic patients (20556 patients) and 15.5% of all spine injuries (1717patients). Most of the patients were males (85.8%), and the most common age group was from 20 to < 40 years (39.0%). Road traffic accidents was the most common cause of CSI (62.2%), followed by falling injuries (32.6%) and lastly heavy object trauma (5.2%). Out of 267 CSI patients, 159 (59.5%) patients had neurological insult, and 77 (28.8%) of them were complete quadriplegics. Traumatic cervical disc prolapse occurred in 63 patients (23.6%), upper cervical spine injuries occurred in 23 patients (16.1%), sub axial cervical fracture type A in 24 patients (15.7%), type B in 32 patients (12%) and type C in 87 patients (32.6%). Preoperative in-hospital mortality rate was 39 patients (14.6%). Conclusion: Although CSI represent only 1% of all traumatic injuries, the consequences are grave; high mortality rates; irrecoverable neurological deficits; and long-term infirmity and enormous economic burden to the society. Every effort should be made to prevent CSI, early and properly manage CSI patients and rehabilitate them to resume their function.