Department of Neurological Surgery, New York Presbyterian Hospital/Och Spine, Weill Cornell Medicine, New York, New York; Department of Neurosciences, Grand Hôpital de Charleroi, Charleroi, Belgium.
Department of Neurological Surgery, New York Presbyterian Hospital/Och Spine, Weill Cornell Medicine, New York, New York; Division of Neurosurgery, Muhimbili Orthopedic and Neurosurgery Institute, Dar es Salam, Tanzania, Africa.
World Neurosurg. 2023 Jul;175:e320-e325. doi: 10.1016/j.wneu.2023.03.080. Epub 2023 Mar 24.
In nations where tree harvesting constitutes a significant aspect of the economy, such as Tanzania, falls from trees represent a prevalent cause of traumatic injuries. This study investigates the characteristics of traumatic spinal injuries (TSIs) resulting from falls from coconut trees. (CTFs).
This was a retrospective study of a prospectively maintained spine trauma database at Muhimbili Orthopedic Institute (MOI). We included patients older than 14 years, admitted for TSI secondary to CTF, and with a traumatism not more than 2 months before the admission. Our study analyzed patient data from January 2017 to December 2021. We compiled demographic and clinical information and details such as the distance from the site of trauma to the hospital, American Spinal Injury Association Impairment (ASIA) scale assessment, time to surgery, AOSpine classification, and discharge status. Descriptive analysis was done using data management software. No statistical computing was done.
We included 44 patients, all of whom were male, with a mean age of 34.3 ± 12.1 years. At admission, 47.7% of the patients had an ASIA A injury, with the lumbar spine being the most commonly fractured level at 40.9%. In contrast, only 13.6% of the cases involved the cervical spine. Most (65.9%) of the fractures were classified as type A compression fractures (AO classification). Nearly all patients admitted (95.5%) had surgical indications, but only 52.4% received surgical treatment. The overall mortality rate was 4.5%. With respect to neurologic improvement, only 11.4% experienced an improvement in their ASIA score at discharge, the majority of who were in the surgical group.
The present study demonstrates that CTFs in Tanzania constitute a substantial source of TSIs, frequently resulting in severe lumbar injuries. These findings underscore the need for the implementation of educational and preventive measures.
在坦桑尼亚等树木采伐对经济有重要影响的国家，从树上坠落是创伤性损伤的一个常见原因。本研究调查了因椰子树（CTF）坠落导致的创伤性脊柱损伤（TSI）的特征。
这是对穆希比利骨科研究所（MOI）前瞻性维护的脊柱创伤数据库的回顾性研究。我们纳入了年龄大于 14 岁、因 CTF 导致 TSI 入院且创伤发生在入院前不超过 2 个月的患者。我们的研究分析了 2017 年 1 月至 2021 年 12 月期间的患者数据。我们收集了人口统计学和临床信息以及详细信息，如创伤部位到医院的距离、美国脊髓损伤协会损伤分级（ASIA）评估、手术时间、AOSpine 分类和出院状态。使用数据管理软件进行描述性分析。没有进行统计计算。
我们纳入了 44 名均为男性的患者，平均年龄为 34.3 ± 12.1 岁。入院时，47.7%的患者存在 ASIA A 级损伤，最常见的骨折部位是腰椎，占 40.9%。相比之下，仅有 13.6%的病例涉及颈椎。大多数（65.9%）骨折为 A 型压缩骨折（AO 分类）。几乎所有入院的患者（95.5%）都有手术指征，但只有 52.4%接受了手术治疗。总的死亡率为 4.5%。在神经功能改善方面，只有 11.4%的患者在出院时 ASIA 评分有所提高，其中大多数在手术组。
本研究表明，坦桑尼亚的 CTF 是 TSI 的一个重要来源，常导致严重的腰椎损伤。这些发现强调了实施教育和预防措施的必要性。
