Original Article

Challenges in comprehensive management of spinal cord injury in India and in the Asian Spinal Cord network region: findings of a survey of experts, patients and consumers

Received:
Revised:
Accepted:
Published online:

The study had been presented as a poster in the Associations of Spine Surgeons of India session at Spine Week 2016 in Singapore. The same has been published as proceedings of the meeting in Asian Spine Journal. (Associations of Spine Surgeons of India 2016. Asian Spine J. 2016 Jun; 10(suppl 1): S1–S31).

Abstract

Study design:

Online survey.

Objectives:

To understand the prevailing scenario of the comprehensive management of spinal cord injuries (SCI) in India and in the Asian Spinal Cord Network (ASCoN) region, especially with a view to document the challenges faced and its impact.

Setting:

Indian Spinal Injuries Centre.

Methods:

A questionnaire was designed which covered various aspects of SCI management. Patients, consumers (spinal injured patients discharged since at least 1 year) and experts in SCI management from different parts of India and the ASCoN region were approached to complete the survey.

Results:

Sixty patients, 66 consumers and 34 experts completed the survey. Difference of opinion was noticed among the three groups. Disposable Nelaton catheters were used by 57% consumers and 47% patients. For reusable catheter, 31% experts recommended processing with soap and running water and 45% recommended clean cotton cloth bag for storage. Pre-hospital care and community inclusion pose the biggest challenges in management of SCI. More than 75% of SCI faced problems of access and mobility in the community. Awareness about SCI, illiteracy and inadequate patient education are the most important factors hindering pre- and in-hospital care. Inadequate physical as well as vocational rehabilitation and financial barriers are thought to be the major factors hindering integration of spinal injured into mainstream society. Strong family support helped in rehabilitation.

Conclusions:

Our study brought out that SCI in India and ASCoN region face numerous challenges that affect access to almost all aspects of comprehensive management of SCI.

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Acknowledgements

We extend our gratitude to all the participants from India and the ASCoN region for their support and participation. There is no funding for this study.

Author information

Affiliations

  1. Spine Service, Indian Spinal Injuries Centre, New Delhi, India

    • H S Chhabra
  2. Research Department, Indian Spinal Injuries Centre, New Delhi, India

    • S Sharma
    •  & M Arora
  3. John Walsh Centre for Rehabilitation Research, Sydney Medical School – Northern, The University of Sydney, Sydney, NSW, Australia

    • M Arora

Authors

  1. Search for H S Chhabra in:

  2. Search for S Sharma in:

  3. Search for M Arora in:

Competing interests

The authors declare no conflict of interest.

Corresponding author

Correspondence to H S Chhabra.

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