title: Retrospective analysis of spinal trauma in patients with ankylosing spondylitis: a descriptive study in Indian population.
abstract: OBJECTIVE
  This study aims to understand the demographics, mode of trauma, hospital stay, complications, neurological improvement, mortality and expenditure incurred by Indian patients with spinal trauma and ankylosing spondylitis (AS).
  
  
  METHODS
  Retrospective analysis of the patient data admitted to a tertiary referral hospital from 2008 to 2013 with the diagnosis of AS and spinal trauma was carried out. The variables studied were demographics, mode of trauma, neurological status, neurological improvement, involved vertebral level, duration of hospital stay, comorbid factors, expenditure and complications during the stay.
  
  
  RESULTS
  Forty-six patients with diagnosis of AS with spine trauma were admitted over the last 5 years with a total of 52 fractures. All were male patients; 58.6% had injury because of trivial trauma and 78.2% patients presented with neurological injury. C5 C6, C6 C7, C7 D1 and D12 were the most common injured level. Fractures through intervertebral disc were most common in cervical spine. Of the patients, 52.7% had shown neurological improvement of at least grade 1(AIS). Mean expenditure of patient admitted with spinal cord injury (SCI) with AS is 7957 USD (United States dollar), which is around five times the per capita income in India (as per year 2013).
  
  
  CONCLUSIONS
  Males with AS are much more prone to spinal fractures than females and its incidence may be higher than previously reported. Domestic falls are the most common mechanism of spinal trauma in this population. High velocity injuries are associated with complete SCI. The study reinforces the need for development of subsidized spinal care services for SCI management.
authors.affiliation: Spine Services, Indian Spinal Injuries Centre, New Delhi, India.
authors.forename: R
authors.initials: R
authors.lastname: Mahajan
authors.affiliation: Spine Services, Indian Spinal Injuries Centre, New Delhi, India.
authors.forename: H S
authors.initials: HS
authors.lastname: Chhabra
authors.affiliation: Spine Services, Indian Spinal Injuries Centre, New Delhi, India.
authors.forename: A
authors.initials: A
authors.lastname: Srivastava
authors.affiliation: Spine Services, Indian Spinal Injuries Centre, New Delhi, India.
authors.forename: R
authors.initials: R
authors.lastname: Venkatesh
authors.affiliation: Spine Services, Indian Spinal Injuries Centre, New Delhi, India.
authors.forename: V
authors.initials: V
authors.lastname: Kanagaraju
authors.affiliation: Spine Services, Indian Spinal Injuries Centre, New Delhi, India.
authors.forename: R
authors.initials: R
authors.lastname: Kaul
authors.affiliation: Spine Services, Indian Spinal Injuries Centre, New Delhi, India.
authors.forename: V
authors.initials: V
authors.lastname: Tandon
authors.affiliation: Spine Services, Indian Spinal Injuries Centre, New Delhi, India.
authors.forename: A
authors.initials: A
authors.lastname: Nanda
authors.affiliation: Spine Services, Indian Spinal Injuries Centre, New Delhi, India.
authors.forename: G
authors.initials: G
authors.lastname: Sangondimath
authors.affiliation: Spine Services, Indian Spinal Injuries Centre, New Delhi, India.
authors.forename: N
authors.initials: N
authors.lastname: Patel
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013119:Spinal Cord Injuries / Q000150:complications* / Q000191:economics / Q000453:epidemiology* / Q000401:mortality; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000191:economics / Q000453:epidemiology* / Q000401:mortality