Epidemiological Characteristics And Correlative Analysis Of Inpatients With Spinal Cord Injury: 221 Case Report

Objective To Analyz the epidemiological characteristics of inpatients with spinal cord injury(SCI), and explored the correlation in these characteristics.Methods Retrospectively descriptive analysis of data of patients with spinal cord injury admitted in department of orthopaedics and department of rehabilitation during August 2006～August 2010 were studied.221 patients according to the forecited grouping principle and the procedure were involved in this study. These factors were taken into observation : age , gender ,occupation,cause,segment of fracture, level of injury, ASIA grade,motor index score (MIS),sensor index score (SIS),Barthel Index(BI) ,patterns of spinal cord changes on Magnetic Resonance Imaging( MRI),complication. Then these data were grouped by age,gender,cause,level of injury,univariate analysis or binary logistic regression analysis was made to explore the correlation of these data(ɑ=0.05). Result A total of 221 patients with SCI,the ages at injury were 12～73 years old (mean 38.29±12.41),and the group aged 20～49 years old accounted for 72.9% of all cases. The main occupations were peasants(48.9%)and workers(19.0%).The leading causes were Motor vehicle accidents (MVA) (38.0%), falling from a height(31.7%),falling down(10.9%),crushing (12.7%).MVA and falling from a height were main cause of patients less than 30 years old. MVA, falling from a height and crushing were three main cause of patients in 30～49 years old. MVA and falling down were much more usually cause of patients older than 50 years old. It was noted in our study that MVA and Falling down were more likely to injure cervical spinal cord,whereas crushing contributed to thoracic and Lumbosacral spinal cord injury. Neurologic deficit was not associated with cause (p>0.05). 197 patients suffered with spine fracture , which accounted for 89.1% of all cases.The most common segments of cervical vertebrae fracture were C4-6 (72.5%),and the most common segments of thoracolumbar vertebrae fracture were T12-L2 (73.6%).The percentage of ASIA grade A in thoracic spinal cord was greater than in cervical or Lumbosacral spinal cord. The distribution of MIS,SIS and BI of cervical spinal cord injury were different with thoracic and Lumbosacral spinal cord injury. The distribution of MIS,SIS and BI were not correlated with cause (p>0.05). Patterns of spinal cord changes on MRI could reflect the extent of neurologic deficit. The incidence of complication was 55.66% , the most frequent complications of SCI were urinary tract infection(44.34%),pressure sore (15.38%)and pneumonia (6.33%).Conclusion Patients with SCI were predominantly young adults. The cause was varied in different age groups .The level of injury was correlated with cause of injury.The extent of neurologic deficit was significantly correlated with the level of injury.The extent of neurologic deficit was not associated with cause . Lower cervical vertebrae and thoracolumbar vertebrae transition segments were the most frequent segments of spine fracture. patterns of spinal cord changes on MRI could reflect neurologic deficit.The incidence of complication was high,urinary tract infection was the most common complication .