Abstract

Introduction: Traumatic injuries of the cervical spine are frequent and are complicated in 15 to 30% of spinal cord injuries. The prognosis depends on the initial spinal cord injuries and the speed of management. We report our experience in order to evaluate our results and to reveal the difficulties of managing these injuries in our work context.

Materials and methods: over a period of 5 years from January 2015 to December 2019, we retrospectively studied 107 cases of cervical spine trauma in the neurosurgery unit of the regional hospital of Thiès (Senegal).

Results: The mean age was 35.7 years with a sex ratio of 12.3. The frequency was 67.7% of all vertebro-medullary traumas. The etiologies were dominated by road accidents (69.2%) with only 10.28% of medicalized transport and an average admission time of 50.28 hours. Neurological signs were present in 77 patients (71.9%) with an ASIA A score in 35.5% of cases and an ASIA B in 18.7% of cases. Dislocations were the dominant lesions (60.7%). Surgery was performed in 75 patients (70%) with complete improvement of motor deficit in 7 cases. The average delay was 34 months.

Conclusion: This study shows the difficulties of management in our context of patients suffering from cervical spine trauma, due to the failure of the emergency management system and the absence of specialized rehabilitation structures for follow-up care.

Keywords: Trauma; Spine; Cervical; Thies

References

1. EL Glaude., et al. “Traumatismes du rachis cervical”. Feuillets de Radiologie 46 (2006): 5-37.
2. Gerbeaux P and Portier F. “Stratégies d’imagerie des traumatismes du rachis cervical”. Presse Med 32 (2003): 1853-1856.
3. Hasler RM., et al. “Epidemiology and predictors of spinal injury in adult major trauma patients : European cohort study”. European Spine Journal 20 (2011): 2174-2180.
4. Chirossel JP., et al. “Traumatismes vertébro-médullaires”. In: Decq P, Kéravel Y, editors. Neurochirurgie. Paris: Universités francophones éditions (1995): 370-393.
5. E Kpelao., et al. “Problématique de la prise en charge des traumatismes graves du rachis cervical en pays sous-développé”. Neurochirurgie 59 (2013): 111-114.
6. Kawu K., et al. “Outcome of conservative treatment of spinal cord injuries in Lagos, Nigeria”. Nigerian Journal of Orthopaedics and Trauma 1 (2010) : 21-23.
7. Frielingsdorf Ka nd Dunn RN. “Cervical sfepine injury outcome-a review of 101 cases treated in a tertiary referral unit”. South African Medical Journal2 (2007): 203-207.
8. Edouard A. “Prise en charge d’un blessé adulte présentant un traumatisme vertébromédullaire”. Ann Fr Anesth Réanim 23 (2004): 930-45.
9. Seltzer S and Freyser M. “Prise en charge initiale des traumatismes du rachis cervical Le praticien en anesthésie-réanimation” 6.5 (2002) :334-339.
10. Argenson C., et al. “Classification des lésions traumatiques du rachis cervical inférieur”. Rachis cervical traumatique. Cahier d’enseignement de la SOFCOT 76 (2000): 42-62.
11. Bracken MB., et al. “Incidence of acute traumatic hospitalized spinal cord injury in the United States, 1970- 1977”. American Journal of Epidemiology 113 (1981): 615-622.
12. Dunn RN., et al. “Rugby and cervical spine injuries - has anything changed? A 5-year review in the Western Cape”. South African Medical Journal4 (2010): 235-238.
13. Babatunde AS. “Spinal cord injuries in Ilorin, Nigeria”. West African Journal of Medicine 3 (2002): 230-232.
14. JM Yanguiayan., et al. “Prise en charge actuelle du traumatisé grave en France : premier bilan de l’étude FIRST (french intensive care recorded in severe trauma)”. Annuelles françaises de médecine d’urgence 2 (2012): 156-163.
15. Robert O., et al. “Stratégie diagnostique des lésions traumatiques du rachis cervical”. Réanimation 13 (2004): 471-476.
16. Loembe PM., et al. “Les traumatismes du rachis cervical. A propos de 40 observations”. Méd. Afr. Noire 33 (1986): 517-541.
17. Narasinga Rao KVL., et al. “Factors affecting longterm outcome in acute cervical cord injury”. Indian Journal of Neurotrauma2 (2010): 149-156.
18. Hadley MN., et al. “Guidelines for the management of acute cervical spine and spinal cord cervical injuries. Radiologic assessment of the cervical spine in symptomatic trauma patients”. Neurosurgery 50 (2002): 36-43.
19. Griffen MM., et al. “Radiographic clearance of blunt cervical spine injury: plain radiograph or computed tomography scan?” Journal of Trauma 55 (2003): 222.
20. Emejulu JKC and Ekweogwu OC. “Outcome of spinal cord injuries managed in a centre without modern imaging facilities”. West African Journal of Medicine 6 (2009): 376-379.
21. Ordonez BJ., et al. “Cervical facet dislocation: Techniques for ventral reduction and stabilization”. Journal of Neurosurgery 92 (2000): 18-23.
22. Kalff R., et al. “Operative spondyladesis in injuries of the lower cervical spine”. Neurosurgery Review 16 (1993): 211-220.
23. PM Loembe., et al. “Fractures et luxations du rachis cervical inférieur (C3-C7) attitudes thérapeutiques au Gabon”. 45 (1998): 628-632.

Citation

Citation: Barry Louncény Fatoumata., et al. “Difficulties in the Management and Prognosis of Cervical Rachis Trauma in a Regional Neurosurgery Unit in a Developing Country: The Example of Senegal".Acta Scientific Orthopaedics 4.3 (2021): 15-20.

Copyright

Copyright: © 2021 Barry Louncény Fatoumata., 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.