The aetiology, pattern and prognosis of fractures of the spine in Dar es Salaam, Tanzania.

To determine the aetiology, pattern and prognosis of fractures of the spine in Dar es Salaam, Tanzania we studied a total of 54 patients who had sustained fractures of the spine and were managed by the Orthopaedic/Trauma Department of Muhimbili Medical Centre from January to December 1992. Of these patients 50 were males and four females. Their ages ranged between 12 and 69 years with a mean of 35.5 years. The 21-30 year age group formed the majority of the patients (48.2 pc). Common causes for fractures of the spine observed were motor traffic accidents (MTA) accounting for 38.9 pc of the fractures, falls from heights (46.3 pc) and injuries from falling objects (11.1 pc). The vertebra in the C3-C5 and T11-L3 regions were most frequently fractured. Neurological deficits were observed in 33 patients (61.1 pc) with paraplegia and quadriplegia dominating the neurological pathology. Full recovery of the neurological deficit was observed in five patients (15.2 pc) and partial recovery in 10 (30.3 pc). The overall case fatality rate was 29.6 pc all of whom had neurological deficit. Cervical spine fractures had the worst prognosis accounting for 43.8 pc of the mortality. All patients except two were treated conservatively. There is a need to disseminate knowledge on the initial care for spinal injury patients so as to improve the prognosis of such patients.