Journal of Emergencies, Trauma, and Shock
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 Table of Contents    
LETTER TO EDITOR  
Year : 2016  |  Volume : 9  |  Issue : 1  |  Page : 43-44
Clinical profile of patients with traumatic cervical spine injury in the emergency department of a tertiary care hospital


1 Department of Emergency, Christian Medical College, Vellore, Tamil Nadu, India
2 Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India

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Date of Submission10-Aug-2015
Date of Acceptance03-Sep-2015
Date of Web Publication13-Jan-2016
 

How to cite this article:
Wills SJ, Pandian GR, Bhanu TK, Kumar KS, Murugan Y, Abhilash KP. Clinical profile of patients with traumatic cervical spine injury in the emergency department of a tertiary care hospital. J Emerg Trauma Shock 2016;9:43-4

How to cite this URL:
Wills SJ, Pandian GR, Bhanu TK, Kumar KS, Murugan Y, Abhilash KP. Clinical profile of patients with traumatic cervical spine injury in the emergency department of a tertiary care hospital. J Emerg Trauma Shock [serial online] 2016 [cited 2020 Jan 17];9:43-4. Available from: http://www.onlinejets.org/text.asp?2016/9/1/43/167668


Sir,

Traumatic cervical spine injury (CSI) is a very disastrous and crippling disease which has a lasting neurological deficit and disability. In India, it is estimated that 20,000 patients have spinal cord injuries and are mostly from the rural population.[1] This prospective observational study was conducted in a Tertiary Hospital in Vellore, South India. The profile of all adult patients presenting with traumatic CSI was studied. The study included 40 patients with CSI during a period of 4 months with an incidence of 1.2% among all trauma cases.[2] The majority of the patients were males (87.5%).[3],[4] In our study, there was an equal distribution of patients between the age group <45 years and >45 years, most of them in the working age group. Road traffic incidents (RTIs) was the most common cause of CSI (62.5%),[4] followed by fall from height (20.0%) and fall on the level ground (17.5%). Two wheeler accidents comprised the majority of RTI (62.5%) followed by four wheeler accidents (20%). The severity of the injury was calculated using the Revised Trauma Score (median score of 8 with an interval of 6-8). Quadriplegia was found to be the most common neurological deficit (23.3%) followed by paraparesis (16.3%), paraplegia (14%), monoparesis (7%), hemiparesis (4.7%), quadriparesis (4.7%), and hemiplegia (2.3%) [Figure 1]. More than one cervical vertebra was injured in 60% of cases. The most commonly injured vertebra was the C5 (21.8%), closely followed by C4 (18.7%) and C6 (20.3%) [Figure 2]. Forty-five percent were unstable injuries. The c5 level is found out to be the most commonly injured cervical spine whereas C1 was found out to be the least affected.[1] Cervical spine trauma is associated with significant morbidity with the lower cervical spine (C3-C7) most commonly involved. Only 10% (4/40) of patients had associated head injury. Associated thoracic vertebra fracture was seen in 2 patients. The majority of patients (87.5%) riding a two wheeler were not wearing a helmet and majority of patients (80%) driving a four wheeler were not wearing a seat belt. Other studies reported only 31% usage of helmets among two wheeler riders in Kerala [5] RTI was the most common cause and hence stricter traffic rules would probably decrease the burden of this devastating injury.
Figure 1: Common neurological manifestation

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Figure 2: Common level of cervical spine injury

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   References Top

1.
Shrestha D, Garg M, Singh GK, Singh MP, Sharma UK. Cervical spine injuries in a teaching hospital of eastern region of Nepal: A clinico-epidemiological study. JNMA J Nepal Med Assoc 2007;46: 107-11.  Back to cited text no. 1
    
2.
Torretti JA, Sengupta DK. Cervical spine trauma. Indian J Orthop 2007;41:255-67.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
3.
Fredø HL, Rizvi SA, Lied B, Rønning P, Helseth E. The epidemiology of traumatic cervical spine fractures: A prospective population study from Norway. Scand J Trauma Resusc Emerg Med 2012;20:85.  Back to cited text no. 3
    
4.
Das S, Datta PP, Das M, De S, Firdoush KA, Sardar T, et al. Epidemiology of cervical spinal cord injury in eastern India: An autopsy-based study. N Z Med J 2013;126:30-40.  Back to cited text no. 4
    
5.
Sreedharan J, Muttappillymyalil J, Divakaran B, Haran JC. Determinants of safety helmet use among motorcyclists in Kerala, India. J Inj Violence Res 2010;2:49-54.  Back to cited text no. 5
    

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Correspondence Address:
Shiju Jesudas Wills
Department of Emergency, Christian Medical College, Vellore, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2700.167668

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