Clinical and epidemiological profile and functionality achieved in patients with traumatic spinal cord injury assisted at the Rehabilitation and Physical Medicine Service at the University Hospital

  • Marta Arriola Universidad de la República, Facultad de Medicina, Cátedra de Rehabilitación y Medicina Física, Prof. Agregada
  • Leticia López Universidad de la República, Facultad de Medicina, Cátedra de Rehabilitación y Medicina Física, Prof. Adj.
  • Teresa Camarot Universidad de la República, Facultad de Medicina, Cátedra de Rehabilitación y Medicina Física, Prof.
Keywords: SPINAL CORD INJURIES, REHABILITATION, ETIOLOGY, EPIDEMIOLOGY

Abstract

Traumatic spinal cord injury may affect all functionalities of the spinal cord, what determines limitation in activity and restrictions in participation. Learning about its epidemiological profile is of the essence to plan healthcare, resources and preventive actions. The Rehabilitation Chair has a long history in providing healthcare to people with traumatic spinal cord injury in multidisciplinary teams. Data has been recorded since 1987, which information was analysed and presented at the National Neurology Conference in 2004.
Objective: to describe the socio-demographic, clinical, functional and therapeutic characteristics of our population.
Method: we conducted a longitudinal, retrospective, descriptive and analytical study of the entire population assisted between 2004 and 2017.
Results: n=70, 86% male, 40±18 years old. The following causes were found: falls 36.4%, road accidents 31.8% and violence 28.8%; cervical level 57%, dorsal spine 40% and lumbar spine 3%. Initial ASIA impairment scale was 36.2% A, 13.8% B, 22.4% C and 5.2% D. Final ASIA impairment scale was 29.0% A, 3.2% B, 27.4% C, 25.8% D.  45% achieved independence in everyday basic activities, 60% transfer independence and 45% independent gait.
Conclusions: the number of new cases decreased in the last 4 years and the etiological profile changed. Young men prevailed, lesions caused by falls, road accidents and violence were the most frequent, incomplete quadriparesis, followed by complete and incomplete paraplegia. The most frequent complications were nephro-urological and pressure sores. As to the functionality achieved, most patients were dependent in every day life activities, they could transfer independently and could not achieve independent gait.

References

1) Kang Y, Ding H, Zhou HX, Wei ZJ, Liu L, Pan DY, et al. Epidemiology of worldwide spinal cord injury: a literature review. J Neurorestoratol 2018; 6:1-9.
2) Vieira R, Gianini L, Bastianello R, Arantes A. Epidemiology of traumatic spinal injuries in Brazil: systematic review. Arq Bras Neurocir 2014; 33(2):100-6.
3) Singh A, Lindsay T, Suhkvinder KR, Nouri A, Fehlings MG. Global prevalence and incidence of traumatic spinal cord injury. Clin Epidemiol 2014; 3:309-31.
4) Cardenas DD, Curt A. Rehabilitation in spinal cord injury. En: Selzer M, Clarke S, Cohen L, Duncan P, Gage F, eds. Textbook of neural repair and rehabilitation. New York: Cambridge University Press, 2006:615-36.
5) Uruguay. Universidad de la República. Rectoría. Ordenanza del Hospital de Clínicas “Dr. Manuel Quintela”. Exp. N.º 151100-0009600. Resol. n.º 05-CDC-13/10/2015.
6) Borelli G, Arriola M, Bachetta L, Aguirrezabal X. El lesionado raquimedular traumático. Características epidemiológicas de la población asistida por el equipo de rehabilitación del Hospital de Clínicas. En: Sociedad Uruguaya de Neurología. II Congreso Nacional de Neurología. 8-11 de setiembre 2004. Colonia, Uruguay.
7) National Spinal Cord Injury Statistical Center. 2017 Annual statistical report for the spinal cord injury model systems public version. Birmingham, AL: University of Alabama at Birmingham, 2017.
8) Martínez F, Algorta M. Lesiones medulares por arma blanca. Presentación de casos clínicos y propuesta de manejo. Rev Urug Med Interna 2017; (1):39-48.
9) National Spinal Cord Injury Statistical Center. 2017 Annual statistical report for the spinal cord injury model systems public version. Birmingham, AL: University of Alabama, 2017.
10) van Middendorp JJ, Goss B, Urquhart S, Atresh S, Williams RP, Schuetz M. Diagnosis and prognosis of traumatic spinal cord injury. Global Spine J 2011; 1(1):1]8.
11) doi:10.1055/s-0031-1296049.
12) van den Berg ME, Castellote JM, Mahillo-Fernandez I, de Pedro-Cuesta J. Incidence of spinal cord injury. Worldwide: a systematic review. Neuroepidemiology 2010; 34:184-92.
13) Kang Y, Ding H, Zhou H, Wei Z, Liu L, Pan D, et al. Epidemiology of worldwide spinal cord injury: a literature review. J Neurorestoratol 2017; 6:1-9. doi:10.2147/ JN.s143236.
14) Spiess MR, Müller RM, Rupp R, Schuld C, van Hedel HJ. Conversion in ASIA impairment scale during the first year after traumatic spinal cord injury. J Neurotrauma 2009; 26(11):2027-36.
15) Kirshblum SC, Botticello AL, Dyson-Hudson TA, Byrne R, Marino RJ, Lammertse DP. Patterns of sacral sparing components on neurologic recovery in newly injured persons with traumatic spinal cord injury. Arch Phys Med Rehabil 2016; 97(10):1647-55.
16) Lee BA, Leiby BE, Marino RJ. Neurological and functional recovery after thoracic spinal cord injury. J Spinal Cord Med 2016; 39(1):67-76.
17) Bazán PL. Significance of SCIWORA in adults. Coluna/Columna 2015; 14(2):134-7.
Published
2021-05-18
How to Cite
1.
Arriola M, López L, Camarot T. Clinical and epidemiological profile and functionality achieved in patients with traumatic spinal cord injury assisted at the Rehabilitation and Physical Medicine Service at the University Hospital. Rev. Méd. Urug. [Internet]. 2021May18 [cited 2024Nov.23];37(2):e37208. Available from: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/709