Analysis of Traumatic Spinal Injuries :- A Prospective Study at a Tertiary care Hospital

Abstract

ABSTRACT

Background: Traumatic spinal cord injuries (TSCIs) are significant contributors to global trauma morbidity and mortality. High-velocity trauma from falls and road traffic accidents commonly cause spine fractures, often resulting in neurological deficits. Understanding the epidemiology and outcomes of TSCI is critical for improving care and prognosis. This study aimed to determine the epidemiological profile of traumatic spine injuries at a tertiary care centre and to evaluate patient outcomes over three months.

Methods: 60 consecutive patients with radiologically confirmed traumatic spinal injuries admitted to a tertiary care hospital between July 2023 and August 2024 were enrolled. Patients were evaluated for demographic data, injury mechanism (falls from height, road traffic accidents, assault, etc.), level of spine involvement (cervical, dorsal, lumbar), fracture classification [American Orthopedic (AO) Spine classification], and neurological status using the American Spinal Injury Association (ASIA) impairment scale. Pain was assessed by visual analog score (VAS). All patients received standard surgical or conservative management under neurosurgical care. Outcomes were measured by changes in ASIA grade and pain scores at 3 months post-injury. Descriptive statistics were used to summarize patient characteristics. Chi-square and t-tests were applied for categorical and continuous comparisons, respectively; p-value < 0.05 was considered significant.

Results: The mean age of patients was 37.6 years (SD 15.9), with 75% aged 20–44 years. There was a male predominance (M:F ratio ≈3.6:1). The most common age group was 20–34 years (n=24, 40%). Falls from height accounted for 66.7% of injuries and road traffic accidents 31.67%, one patient suffered injury due to fall of heavyweight material. Cervical spine injuries comprised 21.7%, while dorsal and lumbar injuries comprised 78.3%. AO Spine classification showed a predominance of Type A (compression) injuries. At presentation, 50% of patients had severe neurological impairment (ASIA grade A–B). By three months, 15 (25%) patients with partial neurological deficit (ASIA B-C-D) improved by at least one ASIA grade; improvement was significantly associated with incomplete initial injury (p <0.05). The mean VAS pain score improved significantly from 5.72 pre-treatment to 0.37 at follow-up in operated patients.

Conclusion: In this cohort of mainly young adults, falls and road accidents were the leading causes of traumatic spine injury. A majority presented with thoracolumbar fractures and significant neurological deficits. Early management led to modest neurological recovery in many patients; incomplete injuries had better outcomes. These findings reinforce the importance of prevention of fall from height (FFH) and Road Traffic Accidents (RTA), and of rapid, standardized care for TSCI. Given the small sample and short follow-up, larger studies are needed to confirm these epidemiological patterns.