Incidence and functional evolution of traumatic injuries of the spine / Incidência e evolução funcional de lesões traumáticas da coluna / Incidencia y evolución funcional de lesiones traumáticas de la columna vertebral

OBJECTIVE: To determine the incidence and functional outcome of traumatic injuries of the spine in the period from January 1, 2013 to December 31, 2013, at the General Hospital "Dr. Rafael Pascacio Gamboa", state of Chiapas, México. METHODS: A retrospective, cross-sectional, descriptive, observational study, where all patients seeking medical and surgical care in the emergency department and inpatient unit for a traumatic spinal injury were included, regardless of age or sex. RESULTS: A sample of 60 patients, of whom 43 were male (71.7%) and 17 females (28.3%), with an average age of 35 was obtained. As for the cause of the injury, falls were the leading cause (61.7%) followed by motor vehicle accidents (35%) and finally, assaults (3.3%). In this sample, 21% had associated injuries being the most common (7.3%) the thoracic trauma. The most common site of injury was the thoracic spine, followed by the lower cervical and finally the thoracolumbar ones. We found that 70% of patients had partial or complete neurological injury, with complete spinal cord transection (Frankel A) being the most frequent lesion in 53%. CONCLUSION: The incidence in our series is similar that the reported in developing countries which have sociocultural problems similar to ours. The same applies to the etiology of these lesions, which is closely linked to social and economic activity in each country or region. .

OBJETIVO: Determinar a incidência e evolução funcional de lesões medulares traumáticas no período de 01 de janeiro de 2013 a 31 de dezembro de 2013, no Hospital Geral "Dr. Rafael Gamboa Pascacio" estado de Chiapas, México. MÉTODOS: Estudo retrospectivo, transversal, descritivo e observacional, onde foram incluídos todos os pacientes que procuraram atendimento médico-cirúrgico na unidade de pronto-socorro e hospitalar, independentemente de idade ou sexo, que tinham lesão traumática na medula espinhal. RESULTADOS: Obteve-se uma amostra de 60 pacientes, dos quais 43 eram homens (71,7%) e 17 mulheres (28,3%), com média de idade de 35 anos. Quanto à causa da lesão, as quedas foram a principal causa (61,7%), seguidas de acidentes com automóveis (35%) e por agressões (3,3%). Do total, 21% dos pacientes tiveram lesões associadas, sendo a mais comum o trauma torácico (7,3%). O local mais comum de lesão foi a coluna torácica, seguido pela cervical baixa e, finalmente, a coluna toracolombar. Verificamos que 70% dos pacientes tiveram lesão neurológica total ou parcial, sendo a transecção completa da medula espinhal (Frankel A) a lesão mais frequente (53%). CONCLUSÃO: A incidência em nossa série é semelhante à relatada em países em desenvolvimento que têm problemas socioculturais semelhantes aos nossos. O mesmo se aplica à etiologia das lesões, que está estreitamente ligada à atividade econômica e social de cada país ou região. .

OBJETIVO: Determinar la incidencia y evolución funcional de las lesiones traumáticas de la columna vertebral en el periodo comprendido del 01 de enero del 2013 al 31 de diciembre del 2013, en el hospital General "Dr. Rafael Pascacio Gamboa" del estado de Chiapas, México. MÉTODOS: Se trata de un estudio retrospectivo, transversal, descriptivo y observacional, donde se incluyeron a todos los pacientes que solicitaron atención médico-quirúrgica en el servicio de urgencias y hospitalización de la unidad, sin importar edad o sexo que presentaron una lesión vertebral traumática. RESULTADOS: Se obtuvo una muestra de 60 pacientes, de los cuales 43 eran del sexo masculino (71,7%) y 17 del sexo femenino (28,3%), con un promedio de edad de 35 años. En cuanto a la causa de la lesión, las caídas ocuparon el primer lugar (61,7%) seguidas de accidentes automovilísticos (35%) y en tercer lugar las agresiones (3,3%). El 21% presentaron lesiones asociadas siendo el trauma torácico el más frecuente (7,3%). El sitio de lesión más habitual fue la columna torácica, seguida de la cervical baja y finalmente las toraco-lumbares. Encontramos que el 70% de los pacientes presentaron lesión neurológica parcial o completa, siendo la sección medular completa (Frankel A) la lesión más frecuente en un 53%. CONCLUSIÓN: La incidencia encontrada en nuestra serie, es similar a la reportada en países en vías de desarrollo quienes cuentan con una problemática sociocultural similar a la nuestra. Lo mismo sucede con la etiología de estas lesiones, la cual se encuentra estrechamente ligada a la actividad social y económica de cada país o región. .

Clinical Characteristics for Nontraumatic Spinal Cord Injury / 中国康复理论与实践

@#Objective To investigate the clinical characteristics of nontraumatic spinal cord injury, including the demographic characteristics,etiology and neurological function. Methods 44 patients with nontraumatic spinal cord injury in the past 4 years were reviewed. Results There were 27 males (61.3%) and 17 females (38.7%) with mean age of 39.85 years (3.5~78). They were followed up for mean of 13.3 (3~23) months. Myelitis (36%) and spinal tumor (including primary and metastatic tumor, 18.1%) were the most common causes, followed by intraspinal tumor (15.9%), vascular disease (13.6%), nontraumatic acute disc herination (6.8%), spinal cord ischemia after non-spinal surgery (4.5%) and hepatic myelopathy (4.5%). Neurological function at the initial admission included tetraplegia in 9 patients, paraplegia in 30 patients, conus medullaris syndrome in 2 patients and cauda equina syndrome in 2 patients. Neurological function of ASIA at the initial admission included A in 14 cases, B in 6, C in 13 and D in 11. 34% patients improved at least one ASIA grade when evaluated at final follow up. Conclusion Nontraumatic etiologies contribute to a significant proportion for spinal cord injury. Patients with nontraumatic spinal cord injury present the clinical characteristics different from traumatic spinal cord injury cases.