Outcome in patients undergoing surgery for spinal injury in an Ethiopian hospital.
OBJECTIVE
The objective of this study was to investigate epidemiology and outcome after surgical treatment for spinal injuries in Ethiopia.


METHODS
Medical records of patients who underwent surgery for spine injuries at Myungsung Christian Medical Center in Addis Ababa, Ethiopia, between January 2008 and September 2012 were reviewed retrospectively. Assessment of outcome and complications was determined from patient consultations and phone interviews.


RESULTS
A total of 146 patients were included (129 males, 17 females). Their mean age was 31.7 years (range 15-81 years). The leading cause of injury was motor vehicle accidents (54.1%), and this was followed by falls (26.7%). The most common injury sites were lumbar (41.1%) and cervical (34.2%) regions of the spine. In 21.2% of patients, no neurological deficit was present before surgery, 46.6% had incomplete spinal cord injury (American Spinal Injury Association [ASIA] Impairment Scale [AIS] Grade B-D), and 32.2% had complete spinal cord injury (AIS Grade A). Follow-up was hampered by suboptimal infrastructure, but information regarding outcome was successfully obtained for 110 patients (75.3%). At follow-up (mean 22.9 months; range 2-57 months), 25 patients (17.1%) were confirmed dead and 85 patients (58.2%) were alive; 49 patients (33.6%) underwent physical examination. At least 8 of the 47 patients (17.0%) with a complete injury and 29 of the 68 patients (42.6%) with an incomplete injury showed neurological improvement. The reported incidences of pressure wounds, recurrent urinary tract infections, pneumonia, and thromboembolic events were 22.5%, 13.5%, 5.6%, and 1.1%, respectively.


CONCLUSIONS
Patients showed surprisingly good recovery considering the limited resources. Surgical treatment for spine injuries in Ethiopia is considered beneficial.
Department of Clinical Medicine K1, University of Bergen;
Martin Andreas
MA
Lehre
Department of Clinical Medicine K1, University of Bergen;
Lars Magnus
LM
Eriksen
Department of Surgery, Neurosurgery Unit, Addis Ababa University;
Abenezer
A
Tirsit
Myungsung Christian Medical Center;
Segni
S
Bekele
Yekatit 12 Hospital, Addis Ababa, Ethiopia; and.
Saba
S
Petros
Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia.
Kee B
KB
Park
Department of Clinical Medicine K1, University of Bergen;|Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway;
Marianne Lundervik
ML
Bøthun
Department of Clinical Medicine K1, University of Bergen;|Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway;
Knut
K
Wester
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005002:Ethiopia; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000453:epidemiology; D013124:Spinal Injuries / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
AAU = Addis Ababa University; AIS = American Spinal Injury Association (ASIA) Impairment Scale; Eastern Africa; MCM = Myungsung Christian Medical Center; SF-8 = Short Form-8 Health Survey; TSCIs = traumatic spinal cord injuries; UTI = urinary tract infection; developing countries; neurotrauma; spinal instrumentation; surgery; traumatic spinal cord injury