Epidemiology of spinal cord injuries in Novosibirsk, Russia

Abstract

The incidence of spinal cord injuries (SCI) in Novosibirsk is 29.7 per million per year. Almost all of these SCI patients (94.3%) are hospitalized to our clinic. Over the past 5 years (since 1989), a total of 196 patients with SCI were admitted. SCI were distributed as follows: cervical, 96 patients (49.0%); thoracic, 54 (27.5%); and lumbar, 46 (23.5%). SCI was diagnosed using computed tomography (CT), magnetic resonance imaging (MRI), pneumomyelography, epidurography, radiography and electrophysiological methods (neuromyography, evoked potentials). All patients had a neurological deficit of varying degree; Frankel grade A, 64 patients (32.7%); B, 22 (11.2%); C, 67 (34.2%); and D, 43 (21.9%). Almost 40% (39.7%) of the patients had unstable fractures, most of them being in the cervical spine. One hundred and ninety patients were operated on, 52 within 3-4 h after trauma. Several types of operation were used: anterior decompression (106 patients); posterior decompression (64 patients); omentomyelopexia (seven patients); meningomyelo-radiculolysis (13 patients). Conservative treatment ('halo' traction) was applied in six patients. No patient was made worse because of the surgery. Twenty four patients had a complete neurological recovery, 113 patients could be reclassified into a higher group (Frankel classification), and 59 patients had no neurological improvement. The overall mortality was 16.8% (13.7 postoperatively).