Journal de la colonne vertébrale

A Demographic Study of Thoracolumbar Junction Fracture in a Developing Country and its Social Impact

Abstract

Asifur Rahman, Dewan Shamsul Asif, Paawan Bahadur Bhandari and Sader Hossain

Introduction: Spinal cord injury due to traumatic accidents is a major cause of disability throughout the world. Among the spinal injury patients more than 30% suffered from Thoracolumbar Spine (TLS) injury with great preponderance to Thoracolumbar Junction (T10-L2) injury. Delay or inappropriate management of these patients leads to a great socio-economical impact on the society.

Methods and materials: This was a prospective study on 38 patients who were admitted in the Neurosurgery Department at Dhaka Medical College and Hospital (DMCH) in the period of January 2010 to December 2011 with thoracolumbar junction injuries and were analyzed regarding demographic patterns after getting approval of the Ethical Committee of Bangladesh College of Physician and Surgeons (BCPS) and DMCH. Patients with single level Thoracolumbar Junction Injury (D10-L2) and who had TLICS score ≥ 4 were included in this study. Patients with TLICS score ≤ 3, multiple level thoracolumbar junction injury, associated other injuries like head injury, abdominal injury, long bone fractures and any pathological thoracolumbar fractures were excluded.

Result: There were 36 males and 2 females with average age of 29.42 ± 8.11 years (range 17-50 years). Fall from height was the commonest (79%) cause of injury. Most of the patients were farmers and came from lower income class. Most of the patients 29(76.3%) were illiterate. The mean time interval from injury to admission was found to be 8.97 ± 10.11 days (2 to 60 days).

Conclusion: In this study large number of patients was in their active period of life. Due to lack of awareness in their working place, proper counseling and appropriate management of these patients eventually become burden to their family and society. This burden can be minimized with good governance regarding safety measurement in working place and raising awareness among people in their active lives.