Cervical spine injuries in a teaching hospital of eastern region of Nepal: a clinico-epidemiological study.

Cervical spine injuries with neural deficits carry significant impact economically, socially and psychologically to the individual and to the society. Risk factors involved, mode of injuries, constraints of management and rehabilitation are different in developing countries. Total 149 patients of cervical spine injuries presented in B.P. Koirala Institute of Health Sciences, Dharan, Nepal were evaluated prospectively for three years. Demographic details, etiology of injury, method and time taken for transportation and treatment method and progression of recovery were recorded. Most commonly involved age group was 30-49 years (44%) with male to female ratio of 4:1. Fall related injury especially from trees was the commonest mode of injury (60%). Patients were transported to hospital without neck immobilization (81%) in a vehicle unsuitable for spinal injuries patient with average delay of two days of injury. 79% had neural deficits among which 42% are with quadriparesis, 31% are with quadriplegia. Associated extra spinal injuries were found in 9% patients. Average hospital stay was 31 days. C5 vertebra was the most commonly injured vertebra. Cervical spine injuries, which has major impact over patient and society is still not adequately addressed by medical and public health system of developing countries like Nepal. Incidence of spinal injuries and its devastating consequences can be reduced by appropriate preventive measures and management along with rehabilitation.