Profile and Outcome of Adult Spine Pathologies Managed in a Neurosurgical Tertiary Care Center in Nepal

Abstract

IntroductionSpine pathology involves a wide spectrum of diseases and needs a multidisciplinary approach including surgery, rehabilitation and psychological support. It increases the burden to the family and society. This study describes spine and spinal cord disease from a neurosurgical unit from a tertiary hospital in Nepal.MethodsThis is a retrospective study which meticulously reviewed all spinal cases admitted between April 2019 to February 2019, in the Department of Neurosurgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. All adult patients of ≥16 years, diagnosed with various spinal diseases were included. Based on thespectra of causative pathologies, the study population was broadly categorized into trauma, degenerative, tumor, vascular and infection. Demographics, other variables, and outcome (in 1 month) were assessed.ResultsA total of 76 patients included in this study. Male preponderance was observed in all categories. Twentyseven patients (35.5%) had traumatic spine injury and fall from height was the most common mode of injury, accounting ˷two-third of the total spinal trauma patients. Cervical segment was involved in twothirdpatients. More than one-third of the spinal patients (34%) had a degenerative disorder involving lumbar and cervical regions, 57.7% and 42.3%, respectively. Spinal infection was diagnosed in 10.5% of the patients with 62.5% diagnosed as Pott’s spine. Overall complications were seen in 18.4%. Pain improved inall patients while overall good outcome with improvement was noted in 63.2% of the patients.ConclusionOur study demonstrated a large patient burden and a clinical profile dominated by preventable causes such as RTA and fall injury. With early treatment and rehabilitation, significant improvement is seen. Further large scale multicenter studies are required to generalize the whole population of Nepal.Keywords: Burden, Nepal, spine trauma, spine pathology