*Shobode MA, *Abubakar K, *Chiroma MM, *Mamman M, *Waheed TA, *Onuminya J. E., *Abubakar MK, *Ekundayo OO,**Salami OOA, *Ibraheem GH.
National Orthopaedic Hospitals, *Dala, Kano and **Igbobi, Lagos
Address for correspondence:
Dr MA Shobode,
Department of Clinical Services,
National Orthopaedic Hospital, Dala, Kano, Nigeria
Background: Although Road Traffic Injuries account for the most common cause of trauma to the spine/spinal cord world over including Nigeria, there is a need to bring to the fore other causes which were hitherto unreported, albeit bizarre, in our sub region.
Objective: To highlight unconventional mechanisms of injury to the spine/spinal cord, clinico-epidemiological profiles and injury patterns/types.
Materials and Methods: 53 patients with unusual mechanisms of spine/spinal cord injury were studied between January 2016 and June 2018. Patient demographics, Clinico-epidemiological data and injury characteristics – types, level of injury, associated injuries were recorded. ASIA IS grade was used to classify the cord injury. Imaging studies including Plain radiographs, CT scan and MRI scan were used to assess the injuries. Treatment modalities were also documented. SPSS version 17 software was used to analyze the data.
Results: The 53 patients were aged 20 to 74 years. All, except 1, were males. Unusual pathomechanics include: Falls from Baobab trees (31), cattle injuries (5), falls from a camel (1), falls in a shallow well (5), falls from a bench (1) among others. Late presentation was common. The sub-axial cervical spine was involved in over 75% of the cases. 1 patient had atlanto-axial dislocation. All had a neurologic impairment with over 70% presenting as ASIA A injury. Burst fracture pattern was predominant with the middle column affected in over 80%. 33 patients were managed with surgical stabilization with some neurological improvement as seen on the ASIA IS. 7 mortalities were recorded including one postoperative death.
Conclusions: Almost all the mechanisms are brazenly audacious and therefore preventable. There is a need to constantly provide education to people exposed to such risky behaviours, workplace/work-related hazards etc.
Keywords: Bizarre, Pathomechanics, Spine/ Spinal Cord Injury.