Traumatic spinal cord injuries at a tertiary care rehabilitation institute in Pakistan.

Objective: To identify the epidemiological pattern of traumatic spinal cord injuries (SCI) presenting at a rehabilitation institute of a developing country.

Methods: Eighty three patients of traumatic SCI admitted at Armed Forces Institute of Rehabilitation Medicine in 2006 fulfilling the inclusion criteria were enrolled. Detailed clinical evaluation and radiological assessment was done along with identification of mechanism of injury, mode of evacuation and presence of associated injuries. Data analysis was done in January 2007 and results were compiled and analyzed using SPSS 13.

Results: There were 68 (81.9%) males and 15 (18.1%) females. Mean age was 28.3 +/- 12.4 years. Majority of the patients were in their second decade 43 (51.8%) years. Ambulance evacuation was carried out in only 18 (22.2%) patients and none received any spinal trauma first aid and log roll at the injury site. Most of the patients were paraplegics 49 (71.1%), 48 (57.8%) had complete injury and 43 (51.8%) spinal fixation. Fracture dislocation was the predominant vertebral column injury in 25 patients. Associated injuries and problems were present in 49.4% patients.

Conclusion: Epidemiology of SCI in a developing country has unique epidemiological features and problems, which is different from a developed country. This was to be considered while formulating a plan for SCI management and rehabilitation. There is a dire need to establish a SCI registry in Pakistan, in order to improve the spinal trauma evacuation protocols and develop spinal rehabilitation centers.