Clinical profile of paediatric spinal cord damage in a developing country’s rural-area tertiary hospital neurosurgery

IF 0.7 Q4 CLINICAL NEUROLOGY
Toyin Ayofe Oyemolade, Amos Olufemi Adeleye, Inwonoabasi Nicholas Ekanem
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Abstract

Spinal cord damage (SCD) is rare in children, hence the paucity of literature on the subject, particularly in developing countries. This study aims to define the clinical epidemiology of paediatric SCD in a Nigerian tertiary health facility. A retrospective review of a 42-month long prospectively collected clinical data on paediatric SCD in a rural neurosurgery unit. There were 37 children (20 males) accounting for about 12% of the paediatric neurosurgical patients we managed during the study period. The mean age was 6.9 years (peak = 0–4 years, 43.2%). Traumatic spinal cord injury (SCI) was the cause of SCD in 54.1% (20/37) of the cases, spinal bifida in 37.8%, spinal cord tumour in 5.4%, and spinal tuberculosis in 2.7%. The mean age of patients with traumatic SCI was 11.5 years, while the median age for spinal bifida was 3 days. Traumatic SCI was caused by road traffic accident in 70% (14/20), and falls in 25%. The cervical spinal cord was the location of the spinal cord damage in 51.4% of all the cases in this study, lumbosacral in 24.3%, and sacral in 10.8%. Traumatic SCI was predominantly located in the cervical region in (90%, 18/20) while spinal bifida was most commonly lumbosacral (64.3%, 9/14). Spinal cord damage accounted for more than a tenth (12.1%) of our paediatric neurosurgical workload in this rural neurosurgery, and are mostly due to traumatic SCI and spinal bifida.
发展中国家农村三级医院神经外科儿科脊髓损伤的临床概况
脊髓损伤(SCD)在儿童中很少见,因此缺乏关于这一主题的文献,特别是在发展中国家。本研究旨在确定尼日利亚三级卫生机构儿科SCD的临床流行病学。回顾性审查在农村神经外科单位的儿科SCD长达42个月的前瞻性收集临床资料。37名儿童(20名男性)约占我们在研究期间处理的儿科神经外科患者的12%。平均年龄6.9岁(高峰= 0 ~ 4岁,占43.2%)。创伤性脊髓损伤(SCI)是SCD的病因,占54.1%(20/37),脊柱裂占37.8%,脊髓肿瘤占5.4%,脊柱结核占2.7%。创伤性脊髓损伤患者的平均年龄为11.5岁,而脊柱裂患者的中位年龄为3天。道路交通事故致创伤性脊髓损伤占70%(14/20),占25%。51.4%的脊髓损伤发生在颈髓,24.3%发生在腰骶部,10.8%发生在骶部。外伤性脊髓损伤主要发生在颈部(90%,18/20),脊柱裂最常见于腰骶部(64.3%,9/14)。在这个农村神经外科中,脊髓损伤占儿科神经外科工作量的十分之一以上(12.1%),主要是由于创伤性脊髓损伤和脊柱裂。
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