title: Cervical spine injury: a ten-year multicenter analysis of evolution of care and risk factors for poor outcome in southeast Nigeria.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To describe the evolution of care and risk factors for poor outcome in patients with cervical spine injury (CSI) treated at three centers in southeast Nigeria.
  
  
  METHODS
  Nigeria, southeast.
  
  
  METHODS
  A 10-year retrospective multicenter analysis of patients with CSI, managed at three centers in southeast Nigeria, from January 2003 to December 2012.
  
  
  RESULTS
  Two hundred and seven patients (55%) had CSI out of 377 spinal injury cases in the three study centers, but 195 cases had complete records and were studied. There were 148 males and 47 females. The age range was 3-74 years with a mean of 32.6 (± 1.9) years 95% CI. Most injuries (149 cases) resulted from motor vehicular accidents (MVA). The C5 spinal level was involved in 75 (38%) cases One hundred and seventeen patients (60%) presented with American Spinal Injury Association A (ASIA A) injury. CSI care evolved from the application of a Minerva jacket or cervical traction only to cervical traction and spinal fusion resulting in a reduction in hospital stay (F = 52.5, DF (2, 3) P < 0.05). When compared to 51 patients with incomplete injuries, who improved in neurologic al status at discharge, only three patients with ASIA grade A experienced some improvement. The mortality rate from our series is 16% (32 patients). Those who died were more likely to have a complete injury (25 patients) or a high cervical injury (X² = 61.2, P < 0.05) among other factors.
  
  
  CONCLUSIONS
  The cervical spine is the most commonly injured spinal segment in southeast Nigeria. Although treatment evolution has resulted in reduction of hospital stay, the associated mortality risk still remains high.
authors: Neurosurgery Unit, Department of Surgery, University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria.
authors: E O
authors: EO
authors: Uche
authors: O E
authors: OE
authors: Nwankwo
authors: E
authors: E
authors: Okorie
authors: I
authors: I
authors: Nnezianya
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D012149:Restraint, Physical; D012189:Retrospective Studies; D012307:Risk Factors; D013123:Spinal Fusion; D013124:Spinal Injuries / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D014143:Traction; D055815:Young Adult