Acute Injuries to the Spine: pattern of Findings as Seen at Plain Radiography a Cross-sectional Study done at Kenyatta National Hospital, Nairobi from March 20, 2010 to December 31, 2010

Abstract

INTRODUCTION Spinal injuries are common and neglected conditions in our setting affecting mainly young adults. The spine injured victim ends up with avoidable complications due to clinicians' failure to offer appropriate management. This study tries to highlight various patterns of findings as seen at plain radiography in a patient with spinal injury and also suggests possible mechanisms of injury. The researcher hopes this information will assist clinicians in planning further management options for the benefit .• of the patient. OBJECTIVE The main objective in this study was to describe the clinical and radiographic findings in patients with Acute Spinal Injury presenting at K.N.H. METHOD A cross-sectional study was carried out at Kenyatta National Hospital within a period of nine months from March 20, 2010 to December 31, 2010 to establish the pattern of findings as seen at plain radiography in patients with acute trauma to the spine. One hundred patients were studied. 4 RESULTS The study group included seventy eight (78%) males and twenty two (22%) females. The overall ratio of male to female patients was 3.5: 1. The age distribution was from 11 - 80+ years and this followed a normal distribution curve. Road Traffic Accidents (RTA) was the leading cause of spinal injury at 49% followed by fall from height 37% and assault at 6%. The most commonly seen spinal injuries are fractures 69.9% followed by fracture dislocations 20.3% and finally dislocations at 7.5%. In 3%, no injuries were seen.. (SCIWORA) despite the patients having neurological symptoms following trauma to the spine. Of the fractures, the commonest type was burst fracture occurring in 27.1% (n = 26) of cases followed by simple wedge fracture occurring in 17.7% (n=17) of cases. Wedge tear drop fractures occurred in 15 (15.6%) cases. Other fractures like Odontoid, Jeffersons and Hangmans fractures etc were seen but in much lower proportions. CONCLUSION Plain radiographs of the spine still remain the most important initial investigation to a patient with acute injury of the spine. When carefully evaluated by the clinician, prompt and appropriate management can be initiated even before other more expensive radiological tests are carried out.