Prospective and Retrospective study of Clinical, Radiological and Social Outcome of Patients with Traumatic Spinal Cord Injuries

Hari Hara Subramanian, R (2020) Prospective and Retrospective study of Clinical, Radiological and Social Outcome of Patients with Traumatic Spinal Cord Injuries. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION: Spinal cord injury is an important cause of morbidity and mortality, having significant impact on the physical, economic and psychosocial aspects of the patients and the society. Prognostication of spinal cord injuries helps in better anticipation of the outcome at each stage of treatment,it also helps in guiding treatment and early rehabilitation measures. AIM OF THE STUDY: To prognosticate the outcome of Spinal cord injuries with the help of ASIA impairment scale at the time of admission and MRI findings in spinal cord after admission (sagittal section of T2-weighted images). MATERIALS AND METHODS: 50 Cases of spinal cord injuries admitted In RGGGH with Traumatic spinal cord injuries are taken up for study and evaluated initially with ASIA Impairment Scale and MRI findings are documented at admission. The outcome id measured using AIS at follow up, Functional impairment scale motor scores and Kuppusamy socioeconomic scale at follow up. RESULTS: 6 Patients were Grade A at admission 4 patients remained grade A at follow up. 33% of patients with Grade A improved to grade D at follow up. Of all the patients with grade B at initial examination 66% of patients showed improvement .Patients who were Grade C at admission were 3. Two of them improved to Grade E at follow up and 1 remained Grade C.24 patients were Grade D at admission 18 patients (75%) improved to Grade E. The imaging analysis of my study population gave the following observations in the patients with cord haemorrhage. N=9 (18%)of my cases had cord haemorrhage. 4 cases were Grade A at admission out of which 3 cases (75%) showed no improvement at follow up. 3 cases were Grade B at admission 2 cases remained Grade B at follow up 66% of the cases showed no improvement at follow up.1 case was Grade C at admission remained Grade C at follow up. Only 1 case was grade D at admission remained Grade D at follow-up 80% of cases with Hemorrhage showed no improvement at follow up. 11 of my cases (22%) had cord contusion at admission. 6 cases (54%). were Grade B at admission, 2 cases were grade A at admission 6/11 patients (54%) showed neurological improvement at follow up by at least 2 grades. But n=2 (18%) reached complete neurology at follow up. 28 cases (56%) had cord edema. 24 cases were Grade D at admission .19 cases Grade E at follow up. 4 cases remained Grade D at follow up (These 4 cases had multiple level cord edema >2). Four cases were grade D At admission 3 cases improved neurologically 22 cases (78.5%) showed improvement all the cases attained complete neurological recovery at follow up. CONCLUSION: We conclude that recovery in cases of Spinal cord injury depends upon the age of patients and mode of injury does not significantly co-relate with the recovery. The initial impact of force that caused the spinal column damage had relationship with recovery. MRI and type of spinal column injury are associated with neurological recovery. Patients belonging to low socioeconomic status have lack of follow up and poor rehabilitation post operatively at home leading to increased morbidity and mortality irrespective of degree of spinal cord injury. Good rehabilitation measures and strict adherence to follow up and proper medical advice at each stage of recovery are more important factors. MRI findings in patients with spinal cord injuries (Type of lesion, Length of lesion), in addition to baseline neurological examination can prognosticate his neurological recovery and Social Outcome.

Item Type: Thesis (Masters)
Additional Information: 221712004
Uncontrolled Keywords: Clinical, Radiological and Social Outcome, Patients, Traumatic Spinal Cord Injuries, Prospective and Retrospective study.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 13 Feb 2021 12:21
Last Modified: 13 Feb 2021 12:21

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