title: Suicide bombing as an unusual cause of spinal cord injury: a case series from Pakistan.
abstract: METHODS
  Descriptive case series.
  
  
  OBJECTIVE
  Describe the unusual etiology and pattern of spinal cord injury due to terrorist suicide bombings in Pakistan.
  
  
  METHODS
  Spinal Rehabilitation Unit, Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Pakistan.
  
  
  METHODS
  Hundreds of suicide attacks on civil and military forces have occurred over the last 6 years in Pakistan. These have resulted in thousands of death and many more injured. Six victims of terrorist suicide bombings were admitted over the years 2006 to 2009, who had a spinal cord injury (SCI). This is the first case series of SCI, secondary to terrorist suicide blast.
  
  
  RESULTS
  All patients were males. The mean age was 30±11 years. Most (five) were injured directly due to splinters from the blast. On admission to rehabilitation, all patients had thoracic complete paraplegia and their SCI was managed conservatively for their spinal injuries. Associated injuries included intestinal perforations, fracture metatarsals, humerus and brachial plexus injury. Pressure ulcer was the commonest complication (3 patients). Two patients had neurological improvement at 1-year follow-up.
  
  
  CONCLUSIONS
  Suicide bombing is an effective weapon of terrorists in the modern world of today. The resulting injuries can be diverse and devastating. Spinal cord injury is an uncommon sequel of suicide bombing, which should be kept in mind while dealing with victims of suicide bombing.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Combined Military Hospital, Sindh, Pakistan. farooqrathore@gmail.com
authors.forename: F A
authors.initials: FA
authors.lastname: Rathore
authors.forename: A
authors.initials: A
authors.lastname: Ayub
authors.forename: S
authors.initials: S
authors.lastname: Farooq
authors.forename: P W
authors.initials: PW
authors.lastname: New
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000150:complications* / Q000473:pathology* / Q000503:physiopathology; D015897:Comorbidity; D006801:Humans; D008297:Male; D010154:Pakistan; D010264:Paraplegia / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D011859:Radiography; D013119:Spinal Cord Injuries / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D013406:Suicide, Attempted / Q000639:trends*; D023481:Terrorism / Q000639:trends*; D013904:Thoracic Vertebrae / Q000293:injuries; D055815:Young Adult