Severity and neurosurgical management of patients with traumatic spinal fractures in Saudi Arabia: a cross sectional study.

INTRODUCTION: Road traffic accidents (RTAs) are the most frequent cause of traumatic spinal injuries (TSIs), which account for up to 33.6% of all spinal fractures. The Kingdom of Saudi Arabia (KSA) is one of the countries which has high rates of SCIs and bears the economic burden of that situation. METHODS: 120 patients were included in this study, using a stringent set of inclusion and exclusion criteria. The patients were followed-up from the point of triage to admission and discharge. We analysed the clinical notes of the patients to determine the severity of their traumatic spinal injuries, the neurosurgical management carried out, and other prognosticating factors such as blood transfusion and the Glasgow Coma Scale (GCS). The data collected was analysed anonymously, and the confidentiality of all participants was respected. RESULTS: Most of the patients were young adults and adolescents under the age of 40 (n = 96). There was a male preponderance of 84.1%. With respect to spinal injury stratification, 55 patients had cervical spine fractures, 10 patients had cervical lacerations, 85 patients had thoracolumbar spinal fractures, and 10 patients had thoracolumbar spinal lacerations. 35 patients had other fractures documented. All 120 patients were followed up to assess the management of their traumatic spinal injuries. 66.6% (n= 80) of all patients were managed conservatively, whereas the remaining 33.3% (n=40) were managed surgically. CONCLUSION: Trauma is an important cause of spinal injuries (TSIs), and untreated TSIs may lead to poor clinical outcome, especially if the cervical region is involved.

Is there a misuse of computed tomography in the diagnostic workup of headache? A retrospective record-based study in secondary health-care facility in Saudi Arabia.

INTRODUCTION: Headache disorders are one of the most prevalent global public-health problems that require placing high demand on health-care Services. Since it is one of the most frequent complaints in clinical practice worldwide, it causes a considerable burden in terms of the social cost. The study aimed to give a guide for the decision on the utilization of computed tomography (CT) in the diagnostic workup and identify if patients require neurological imaging (CT) for proper diagnosis or not. MATERIALS AND METHODS: The study was carried out in the Radiology Department in King Khalid Hospital, Al Kharj, Saudi Arabia from October 15, 2016, to February 15, 2017. A retrospective record-based study conducted using the documented CT reports in the files of patients whom were referred to the radiology department complaining of any type of a headache. RESULTS: The data included 210 patients 51% were males and 49% were females. The patients were distributed into age groups; the mean age was 38.46 standard deviation ± 13.56. Among Saudi population, the etiology of headache was varying; the most prevalent type of headache was tension headache 25.71% of the total headache patients followed by cluster 25.24% and the migraine with the lowest proportionality. The majority of the patients' headache pain was mild 60%. Moreover, the CT reports for most of the patients were normal. Spearman Correlation test was used to see if there is a significance in using the CT for any patient who comes with symptoms including headache, and the results have shown that there is no association and clinical significance in using the CT for patients with headache without suspecting other clinical condition (P = 0.177). CONCLUSION: Headache disorders must be on the public-health agenda. Tension, migraine, and cluster-type headaches represent the majority of primary headaches. Statistically no significance or need to obtain CT if there are no life-threatening conditions expected or trauma presented.