Shrestha D, Garg M, Singh G K, Singh M P, Sharma U K
Dhulikhel Hospital, School of Medical Sciences, Kathmandu University Dhulikhel, Nepal.
JNMA J Nepal Med Assoc. 2007 Jul-Sep;46(167):107-11.
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.
伴有神经功能缺损的颈椎损伤对个人和社会在经济、社会及心理方面都产生重大影响。在发展中国家，所涉及的风险因素、损伤方式、管理及康复的限制均有所不同。尼泊尔达兰的BP柯伊拉腊健康科学研究所对149例颈椎损伤患者进行了为期三年的前瞻性评估。记录了人口统计学细节、损伤病因、运输方式及时间、治疗方法以及恢复进程。最常涉及的年龄组为30 - 49岁（44%），男女比例为4:1。与跌倒相关的损伤，尤其是从树上跌落，是最常见的损伤方式（60%）。患者在未进行颈部固定的情况下（81%）被送往医院，乘坐的车辆不适合脊柱损伤患者，受伤后平均延迟两天。79%的患者存在神经功能缺损，其中42%为四肢轻瘫，31%为四肢瘫痪。9%的患者伴有脊柱外损伤。平均住院时间为31天。C5椎体是最常受伤的椎体。像尼泊尔这样的发展中国家的医疗和公共卫生系统仍未充分应对对患者和社会有重大影响的颈椎损伤问题。通过适当的预防措施、管理以及康复，可以降低脊柱损伤的发生率及其灾难性后果。
