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开伯尔-普赫图赫瓦省两家主要三级护理医院报告的创伤性和非创伤性脊柱损伤的频率及原因

Frequency and Causes of Traumatic and Non-traumatic Spinal Injury Reported at Two Major Tertiary Care Hospitals of Khyber Pakhtunkhwa.

作者信息

Ullah Sadiq, Khalid Syed Yousaf, Iftikhar Syed Muhammad Shoaib

机构信息

Neurosurgery, Rehman Medical Institute, Peshawar, PAK.

General Practice, Somerian Health Abu Dhabi, Abu Dhabi, ARE.

出版信息

Cureus. 2023 Jan 1;15(1):e33230. doi: 10.7759/cureus.33230. eCollection 2023 Jan.

Abstract

Introduction Spinal cord injury, due to traumatic or non-traumatic causes, is a medically challenging and life-disrupting condition. The injury disrupts neural signaling and is a medical emergency requiring immediate treatment that can reduce long-term effects like paralysis or partial disability of the body. It has costly consequences both for individuals and families because it causes not only physical disability but dependency on others. The main objectives of the study were to determine the frequency of spinal injuries, their nature, and their causes. Materials and methods A descriptive exploratory study was conducted in the neurosurgery wards of two major hospitals of Peshawar, Lady Reading Hospital and Hayatabad Medical Complex. Necessary permission was taken from the administration of both hospitals before starting data collection. The duration of the study was three months, from October to December 2014. A total of 768 patients were retrieved from the ward records for 2013, from which a 50% random sample was taken (384 patients) while incomplete patient records were excluded. The data were transferred and recorded on a pre-constructed proforma covering all the required variables of the study. Finally, the data were transferred to SPSS 15 (SPSS Inc., Chicago) for analysis of descriptive statistics. In addition, comparisons were done by gender, hospitals, types of injuries, and causes of injuries. The chi-square test was used to compare groups for significant differences in frequencies, keeping p ≤0.05 as significant. Results Major factors for spinal cord injury were traumatic and non-traumatic. This study revealed that out of the total patients, 35% faced trauma as a cause of spinal disorder out of which 42%, 29%, and 21% were sudden falls, road traffic accidents (RTAs), and weight lifting, respectively. While non-traumatic causes were 52% mostly due to congenital anomalies (24%), stenosis (23%), and tumor (12%). Levels most commonly involved were lumbar (42.3%) followed by patients involving multiple levels (32.52%), L5-S1 (20.87%), thoracic (2.42%), and cervical (1.92%). Conclusions The traumatic injury was the leading cause of spinal cord injury in the present study where RTAs and falls contributed the most. Congenital abnormalities and spinal cord stenosis were more frequent among non-traumatic spinal cord injuries. The surgical approach was the only way of management practiced for spinal cord injuries in both of the tertiary care hospitals.

摘要

引言 脊髓损伤,无论是由创伤性还是非创伤性原因引起,都是一种在医学上面临挑战且会扰乱生活的病症。这种损伤会破坏神经信号传导,是一种需要立即治疗的医疗急症,及时治疗可减少诸如瘫痪或身体部分残疾等长期影响。它对个人和家庭都造成了高昂的代价,因为它不仅导致身体残疾,还使人依赖他人。本研究的主要目的是确定脊髓损伤的发生率、损伤性质及其原因。

材料与方法 在白沙瓦的两家主要医院——雷丁夫人医院和哈亚塔巴德医疗中心的神经外科病房进行了一项描述性探索性研究。在开始数据收集之前,已获得两家医院管理部门的必要许可。研究持续时间为三个月,从2014年10月至12月。从2013年的病房记录中检索出768例患者,从中抽取50%的随机样本(384例患者),同时排除不完整的患者记录。数据被转移并记录在一个预先构建的包含研究所有所需变量的表格上。最后,数据被转移到SPSS 15(SPSS公司,芝加哥)进行描述性统计分析。此外,还按性别、医院、损伤类型和损伤原因进行了比较。采用卡方检验来比较组间频率的显著差异,将p≤0.05视为具有显著性。

结果 脊髓损伤的主要因素是创伤性和非创伤性的。本研究显示,在所有患者中,35%的脊髓损伤是由创伤引起的,其中分别有42%、29%和21%是因突然跌倒、道路交通事故(RTAs)和举重所致。而非创伤性原因占52%,主要是先天性异常(24%)、狭窄(23%)和肿瘤(12%)。最常受累的节段是腰椎(42.3%),其次是多节段受累患者(32.52%)、L5 - S1(20.87%)、胸椎(2.42%)和颈椎(1.92%)。

结论 在本研究中,创伤性损伤是脊髓损伤的主要原因,其中道路交通事故和跌倒的影响最大。先天性异常和脊髓狭窄在非创伤性脊髓损伤中更为常见。手术方法是两家三级护理医院治疗脊髓损伤所采用的唯一管理方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8f2/9889235/32b9a16a0b55/cureus-0015-00000033230-i01.jpg

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