Over the years, outcome of injuries to the spine have changed. This has been achieved by better understanding of the factors that produce injury and improved care. But still it is a major challenge to cure associated neurological deficit. The science is working on it and hopeful to find a method but as of now we do not have a way to treat neurological loss in pure sense.
Most common injuries in a trauma victim are head injuries and skeletal injuries. Injury to the spinal column is relatively less common and has a prevalence of 6%. it could be at a single level or may involve multiple non contiguous vertebrae. Roughly 20% of spine injury patients have involvement of multiple levels.
50% of patients of spine trauma have associated neurologic involvement which is caused by injury to spinal cord or nerve roots.
Spine injury with spinal cord involvement is a complex situation. Its management is highly specialized and multifaceted. Spinal cord injury management requires
- Extended acute care
- lifelong chronic care.
- Lifelong social adjustments if there is residual deficit.
Most people affected with this injury are young and active. Not only the condition has a high mortality rate but also the residual disability produces huge functional, medical, and social burden .
The most common causes of spinal cord injuries in order of decreased frequency are
- Motor vehicle accidents. it is responsible for >50% of injuries
- Gunshot injury and sports that include falls such as diving.
Cervical spine is most commonly involved part of the spine in traumatic spine injuries and is most devastating too. This i sfollowed by lumbar and thoracic injuries.
Nearly half of the patients have a complete neurologic injury on initial presentation.
These injuries mainly occur in young males with data suggesting a four time gender prominence.
Epidemiology of Cervical Spine Fractures
The cervical spine is involved in more than half of all spine injuries in trauma patients.
Most isolated thoracic and lumbar fractures are related to osteoporosis. Thoracic and lumbar fractures account for 30% to 60% of all spinal injuries.