Spinal injury in South Trinidad - rationale for a spinal unit - Pster abstract

ABSTRACT

OBJECTIVE: To determine the quantum and patterns of serious spinal injury in a population of half a million persons in South Trinidad and to determine if there is a need for a spinal unit. DESIGN and METHOD: Charts of all cases of serious spinal injury from January 1991 to December 1995 were reviewed and data collected on demographic and injury details, neurologic deficit, admitting and managing units, management, complications, duration of stay and outcome. RESULTS: There were 160 cases mainly in the third to fifth decades, malefemale 31. Labourers outnumbered sedentary workers 21 and more than 1/3 fell from heights. Injuries were in the lumbo-sacral spine (50 percent), cervical (33 percent) and thoracic (25 percent) areas. Neurologic deficit was present in 38 cases and 16 other had potentially disabling injuries. The majority (112) were admitted to orthopaedics; 26 to general surgery and 37 cases were referred to neurosurgery and 32 cases were managed jointly by orthopaedics and neurosurgery. Management was by cervical collars, calipers 5, Minerva jackets 10, plaster jackets 88 and surgical treatment 17. Complication were mainly pressure sores and urinary tract infections. Mortality was 5, all quadriplegic. Hospital stay averaged 21.5 days. CONCLUSIONS: In South Trinadad from 1991-1995 a total of 54 cases of spinal injury had neurological deficit or potentially disabling injury and might have benefited from a spinal unit with joints management by specialists in several disciplines including nurses, technicians and social workers. A unit of 4-6 beds may be appropriate. (Au)