Patterns of Findings Among Cervical Spine Trauma Patients as Observed on Ct Scan Imaging Among Adult Patients at Kenyatta National Hospital

Abstract

Background: Around 10% of spinal cord injuries are accounted for by cervical spine injuries, which are associated with increased mortality, especially when not detected on time. Cervical trauma occurs in approximately 3-15% of all spinal injuries. Blunt trauma is the most significant type of cervical spine trauma. The detection of cervical trauma has been done using radiography in most cases. However, Computerized Tomographic (CT) scan has been associated with more accurate results, which is essential in the early detection and management of cervical trauma cases among patients. The use of CT in identifying patterns of findings in cervical trauma patients has not been exhaustively addressed in the local setting. The purpose of the study: To identify patient characteristics, causes of cervical spine trauma and patterns of findings among cervical spine trauma patients observed on CT scan among adult patients at Kenyatta National Hospital. Methods: This was descriptive cross-sectional study. The target population included cervical spine injury patients diagnosed with cervical trauma at Kenyatta National Hospital Accident and Emergency Department. A purposive sampling technique was used to sample 73 respondents. A structured questionnaire was used to obtain respondent information. Data analysis was done descriptively and presented in charts and tables. Data analysis was performed using Statistical Package for Social Sciences (SPSS version 25). Results: Most of the patients with cervical trauma injuries were male accounting for 93% (n =70). The findings from analysis revealed that 44% (n =33) of the respondents were aged between 18 and 29 years , 40% (n =30) of the respondents were aged between 30 and 39 years, 6.7% (n =5) of the respondents were aged between 40 and 49 years while 9.3% (n =7) were aged 50 years and above. The results identified that 69.3% (n =52) of patients recruited had road accident, 7% had cervical spine trauma resulting from fall, 6.5% (n =5) had cervical spine trauma resulting from sports, 5.3% (n =4) cited violence while 3.9% (n =3) cited other causes which included hit by stone and police abuse. In investigating the patterns of findings, 50.7% (n =38) had Cervical Hypolordosis, 33.3% (n =25) of the respondents had normal CT scans. Major patterns that were identified include 5.3% (n =4) of the participants who had hyperextension with superimposed and a similar percentage had anterolisthesis of vertebral, 4% (n =3) had extension teardrop fracture. Other patterns that were observed include bilateral inter-facetal dislocation (n =2), Unilateral interface dislocation (n =1), flexion teardrop fracture (n =1), hangman’s fracture (n =1), Jefferson fracture (n =1), odontoid fracture (n =2). Conclusion: The findings have showed that most of the patients were male and aged below 40 years. Road accidents were major causes of cervical spine trauma. Half of the patients only reported cervical hypolordosis as the major pattern. Thus, there need to create increased awareness on road safety to prevent road accidents resulting in cervical spine trauma as well as revise the policy on potential cervical spine trauma review on CT for possible pattern through fully assessing patient for cervical spine trauma injury.