Abstract

Introduction: The role of physiotherapy in the management and rehabilitation of spinal cord injury (SCI) patient is well documented. SCI is an enormous devastating condition which affect most commonly young and productive age group of predominantly male population with motor vehicle accidents accounting for the highest incidence.

Method: This is a retrospective review of cases of spinal cord injured patient as seen in the Department of Physiotherapy University College Hospital Ibadan, Nigeria, over the 7 year period, January 1, 2006 to December 31, 2012. The case note accessed account for both out patients and in-patient seen at the hospital for the period under review. Information regarding Age, Gender, Marital Status, Occupation, Year of admission, Religion, Diagnosis/Frankel classifications, Neurological levels and Discharge pattern were retrieved using a spread sheet. Descriptive statistics of frequency, percentage, range, mean and standard deviation were used to summarize data.

Result: Two hundred and twenty six patients, 154 (68.1%) male and 72 (31.9%) female (M: F=2:1), were studied. Their age ranged from 13 to 81 years with a mean age of 43.24years. One hundred and eighty eight (61.9%) had traumatic SCI out of which a total of 103 (45.4) resulted from RTA, fall accounted for 30 (13.2%) cases and 2(0.9%) from penetrating injuries. At presentation 70 (31.0%) patients present with grade A, 33 (14.6%) patients were B, 48 (21.2%) patients had C, and 34 (15.0%) patients had grade D. However at discharge 49 (21.7%) patients had grade A, 22 (9.7%) patients with grade B, 22 (9.7%) patients had C, 57 (25.2%) patients had D while 4 (1.8%) patients had E. Etiology of SCI was found to be significantly associated with each of age (χ²= 35.19; p = 0.00) and marital status (χ²= 35.19; p = 0.00) respectively.

Conclusion: The pattern of SCI from this study showed that RTA is the most common cause affecting mostly young male. The cervical injury was the most implicated in this study and appreciable amount of patient discharged from the ward continued rehabilitative management.

Keywords: Spinal Cord; Physiotherapy; RTA

References

1. Harvey LA. “Physiotherapy rehabilitation for people with spinal cord injuries”. Journal of Physiotherapy1 (2016): 4-11.
2. Saboe LA., et al. “Spinal trauma and associated injuries”. Journal of Trauma 31 (1991): 43-48.
3. Thurmann DJ., et al. “Surveillance of spinal cord injury in Utah, USA”. Paraplegia 32 (1994): 665-669.
4. Thuret S., et al. “Therapeutic interventions after spinal cord injury”. Nature Reviews Neuroscience 7 (2006): 628-643.
5. Ackery A., et al. “A globalperspective on spinal cord injury epidemiology”. Journal of Neurotrama 21 (2004): 1355-1370.
6. Burt AA. “The epidemiology, natural history andprognosis of spinal cord injury”. Current Orthopaedics 18 (2004): 26-32.
7. Kawu A., et al. “A cost analysis of conservative management of spinal cord-injured patients in Nigeria”. Spinal Cord 49 (2011): 1134-1137.
8. DeVivo M and Stover S. “Long term survival and causes of death”. in Stover SL, DeLisa JA, Whiteneck GG (eds): Spinal Cord Injury: Clinical Outcomes from the Model Systems. Gaithersburg, Md, Aspen Publishers, (1995): 100-119.
9. Myers J., et al. “Cardiovascular disease in spinal cord injury: an overview of prevalence, risk, evaluation, and management”. American Journal of Physical Medicine and Rehabilitation 86 (2007).
10. Okonkwo CA. “Spinal cord injuries in Enugu, Nigeria: preventable accidents”. Paraplegia 1 (1998): 12-18.
11. Oyesiku NM. “Cervical Spine Immobilization before Admission to the Hospital”. Neurosurgery 50 (2002): S7-17.
12. World Health Organization (2013).
13. Nwankwo OE and Katchy AU. “Outcome of a 12-week programme for management of the spinal cord injured with participation of patient’s relations at Hilltop Orthopaedic Hospital, Enugu, Nigeria”. Spinal Cord 41 (2003): 129-133.
14. Obalum DC., et al. “Profile of spinal injuries in Lagos, Nigeria”. Spinal Cord 47 (2009): 134-137.
15. Draulans N., et al. “Aetiology of spinal injuries in Sub-Saharan Africa”. Spinal Cord 49 (2011): 1148-1154.
16. Garshick E., et al. “A prospective assessment of mortality in chronic spinal cord injury”. Spinal Cord 43 (2005): 408-416.
17. Udosen A., et al. “A Prospective Study Of Spinal Cord Injury In The University Of Calabar Teaching Hospital, Calabar, Nigeria: A Preliminary Report”. The Internet Journal of Orthopedic Surgery1 (2006).
18. Kawu AA., et al. “Outcome of conservative treatment of spinal cord injuries in Lagos, Nigeria”. Nigerian Journal of Orthopaedics and Trauma 9 (2010): 21-23.
19. Nwadinigwe CU and Ugezu AI. “Management of penetrating spinal cord injuries in a non spinal centre: Experience at Enugu, Nigeria”. Nigerian Journal of Medicine 17 (2008): 205-209.
20. Neumann CR., et al. “Risk factors for mortality in traumatic cervicalspinal cord injury: Brazillian data”. Journal of Trauma 67 (2009): 67-70.
21. Solagberu BA. “Spinal cord injuries in Ilorin, Nigeria”. West African Journal of Medicine3 (2002): 230-232.
22. Odeku EI and Richard R D. “Peculiarities of Spina Trauma in Nigeria”. West African Medical Journal 20 (1971): 211-225.
23. Ebong W W. “Fall from trees”. Tropical Medicine and Global Health 30 (1978): 63-67.
24. Levy LF., et al. “Problems, struggles and some success with spinal cord injury in Zimbabwe”. Spinal Cord 36 (1998): 213-218.
25. Gosselin RA and Coppotelli C. “A follow-up study of patients with spinal cord injury in Sierra Leone”. International Orthopaedics 29 (2005): 330-332.
26. Roohi SA., et al. “Spinal injury in a level-one trauma centre: demographic study”. Medical Journal of Malaysia 61 (2006): 30-35.
27. O’Connor RJ and Murray PC. “Review of spinal cord injury in Ireland”. Spinal Cord 44 (2006): 445-448.
28. Leonard H Joseph., et al. “Three-year study of spinal cord injury outcomes and related secondary complications in a tertiary centre - a retrospective analysis”. Archives of Medical Science2 (2009): 190-194.
29. William O McKinley., et al. “Nontraumatic Spinal Cord Injury: Incidence, Epidemiology and Functional Outcome”. Archives of Physical Medicine and Rehabilitation 80 (1999).
30. Imle PC., et al. “The physical therapists role in the early management of acute spinal cord injury”. Top Acute Care Rehabilitation 3 (1987): 32-47.
31. Sheel AW., et al. “Respiratory management following spinal cord injury”. In: Eng JJ, Teasell RW, Miller WC, et al., editors. Spinal Cord injury Rehabilitation Evidence. Vancouver, BC:ICORD Press (2006): 8.1-8.3.
32. Harvey L. “Respiratory management”. In: Anonymous, editor. Management of spinal cord injuries: Aguide for Physiotherapist. Vol 1. New York: Elsevier Ltd (2008): 205-225.
33. Enel J. “Management of Patient with Spinal Cord Injury”. JAMA10 (1960): 1263-1265.
34. Iwegbu CG. “Traumatic paraplegia in Zaria, Nigeria: the case for a centre for injuries of the spine”. Paraplegia 2 (1983): 81-85.
35. Silver J R and William S J. “Initial management of spinal injury”. In: Current Surgical Pravtice Volume 4. Hadfield J, Hobsley M, editors. Londen; Edward Arnold (Publishers) Ltd. (1989): 60-79.
36. Torlincasi AM and Waseem M. “Cervical Injury”. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing (2020).
37. Umaru H and Ahidjo A. “Pattern of spinal cord injury in Maiduguri, North Eastern Nigeria”. Nigerian Journal of Medicine 3 (2005): 276-278.

Citation

Citation: Olukoju Idowu., et al. "A Seven Year Retrospective Review of Spinal Cord Injury Managed at a Physiotherapy Clinic in a South-western Tertiary Hospital in Nigeria". Acta Scientific Neurology 3.12 (2020): 45-50.

Copyright

Copyright: © 2020 Olukoju Idowu., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.