Title: Comparative Study of Outcome of Treatment of Traumatic Paraplegia by Hartshill Fixation vs Pedicle Screw Fixation

Authors: Dr Vishal Prakash, Dr Ajay Kumar Mahto, Dr Shanawaz Hussain, Dr MasroorAlam

 DOI: https://dx.doi.org/10.18535/jmscr/v6i10.207

Abstract

Introduction

Epidemiological factors of spinal cord injury in Indian scenario are different from western countries with major cause being fall. The low socio-economic status and younger age group had a major financial, social and psychological impact as majority of the patients were the primary earning members of the family. According to a study (Mathur N et al .2015), among 2716 cases of Spinal cord injury, 1400 were cervical and 1316 thoracolumbar, with male to female ratio of 4.2:1 and 71% in the age group of 20-49 years. Around 79% patients were from rural background. About 23.3% were farmers while 22.9% were laborers. Among the causes of injury, 53% patients had a fall from height and 28% suffered from road traffic accidents. Fall of heavy object over the head and back (10.7%), fall with heavy object over the head (3.0%) and fall following electric shock (4.0%) were uncommon causes. Complete paralysis was found in 20.5% cervical and 23.3% in thoracic injuries. Extremity and rib fractures (10.6%) and head injuries (7.2%) were common associated injuries. About 55% cases were initially attended at non-specialized centres. Proper bladder and bowel management in early phase was lacking. However according to another study conducted at Indian Spinal Injury Centre, New Delhi, the mean, median and mode for the age were 34.4, 32 and 30 years, respectively. Male: female ratio was 5.9:1. RTA was the most common (45%) and fall from height the second most common (39.63%) mode of injury. Overall, 66.67% suffered from paraplegia and 71.18% had complete injuries. The study suggests that the demographics of spinal injury in India differs significantly from that in the developed countries since there was a lower mean age, much larger number of males, married individuals, injuries due to two-wheeler accidents/falls, paraplegics and complete injuries.

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Corresponding Author

Dr Vishal Prakash

Junior Resident, KMCH Katihar, India