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在一个东非国家治疗胸腰椎不完全性脊柱损伤的四年经验。

A four year experience treating incomplete thoracolumbar spine injuries in an East African country.

作者信息

Admasu Azarias K, Kebede Sisay

机构信息

Neurosurgery Unit, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

World Neurosurg X. 2023 Apr 5;19:100175. doi: 10.1016/j.wnsx.2023.100175. eCollection 2023 Jul.

Abstract

BACKGROUND

Traumatic spine injuries are one of the most common causes of disability and mortality.

OBJECTIVE

To assess post op neurologic status in patients with incomplete thoracic and lumbar spine injuries at two teaching hospitals in Addis Ababa, Ethiopia.

METHODS

Institution based retrospective cross-sectional study was conducted among 60 hospitalized patients in these hospitals from February 1, 2017-January 31, 2021.

RESULTS

Forty five (75.0%) of the study participants were males. The mean age was 30.77 years (range: 12-65 year). Only 8(13.3%) patients were operated within 3 days of trauma. The most common injury site was the thoracolumbar junction (T11-L2) in 80.0%. Significant number of patients (56.7%) had sphincters dysfunction. Pedicle screw fixation with or without laminectomy was performed in 98.3%. After minimum six month follow up, 37(61.7%) patients had access to the physiotherapy. Thirty seven (61.7%) patients were non ambulatory (AIS B and C) at presentation, of which 29 (78.4%) were ambulatory on the follow-up. Overall, 54(90%) patients had neurologic improvement on the follow up and 37(61.7%) returned to work. Preoperative neurologic status and sphincter function were found to be significantly associated with treatment outcome with respectively.

CONCLUSION

This study shows despite limited availability of post op physiotherapy, significant number of patientsreturned to work post-surgery. Preoperative neurologic function was an independent predictor of post-operative outcome.

摘要

背景

创伤性脊柱损伤是导致残疾和死亡的最常见原因之一。

目的

评估埃塞俄比亚亚的斯亚贝巴两家教学医院中胸腰椎不完全损伤患者术后的神经状况。

方法

对2017年2月1日至2021年1月31日期间这两家医院收治的60例住院患者进行基于机构的回顾性横断面研究。

结果

45名(75.0%)研究参与者为男性。平均年龄为30.77岁(范围:12 - 65岁)。只有8名(13.3%)患者在创伤后3天内接受了手术。最常见的损伤部位是胸腰段交界处(T11 - L2),占80.0%。相当数量的患者(56.7%)存在括约肌功能障碍。98.3%的患者进行了椎弓根螺钉固定术,伴或不伴椎板切除术。经过至少6个月的随访,37名(61.7%)患者接受了物理治疗。37名(61.7%)患者在就诊时不能行走(美国脊髓损伤协会损伤分级B级和C级),其中29名(78.4%)在随访时能够行走。总体而言,54名(90%)患者在随访时神经功能有改善,37名(61.7%)患者恢复了工作。术前神经状况和括约肌功能分别与治疗结果显著相关。

结论

本研究表明,尽管术后物理治疗的可及性有限,但仍有相当数量的患者术后恢复了工作。术前神经功能是术后结果的独立预测因素。

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