Citation

Kpelao E, Diop A, Beketi K, Tine I, Thioub M, Thiam AB, Ba MC. Neurochirurgie (Paris) 2013; 59(3): 111-114.

Vernacular Title

Problématique de la prise en charge des traumatismes graves du rachis cervical en pays sous-développé

Affiliation

Clinique neurochirurgicale, CHU de Fann, avenue Cheikh Anta Diop, BP 5035, Dakar-Fann, Sénégal. Electronic address: kpelas77@yahoo.fr.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.neuchi.2013.04.008

PMID

23796721

Abstract

BACKGROUND AND PURPOSE: The management of cervical spine injuries requires a multidisciplinary approach based on emergency management and rehabilitation. In our context this chain fails, especially on the post-hospital care. Our goal is to explain the difficulties we had in the management of these patients in Dakar. METHODS: This retrospective cohort study (2005-2009) included 99 patients admitted for severe cervical spinal cord injury in two hospitals in Dakar. The clinical signs, treatment and outcome were studied. The follow up was between 3 and 54 months. RESULTS: The average age of patients was 36.1 years and the traffic accidents were the main etiology (73.7%). Medical transport of patients was done in 65.7% with an admission average time of 64.86hours. On admission, 57.6% of patients had Frankel score A or B. Dislocations (59.6%) and Tear drop fractures (16.2%) were the main lesions. The surgery was performed in 83.8% with a mean interval of 128.84hours after the trauma. Outpatient rehabilitation was offered whatever the patient's neurological status. Recovery was complete in 20.2% and partial in 31.3% with a mortality rate of 37.4%. Most deaths occurred between 1 and 6 months (59.5%) mainly due to decubitus complications (56.8%). CONCLUSION: The efficacy of the management of severe spinal cord injuries is based on reducing the preoperative time and rehabilitation.

Language: fr