Epidemiology of Non-Morbid Vertebro-Medullary Trauma Following Road Accidents in the Forensic Casuistry of Bihor County, Romania

Introduction: Vertebro-medullary trauma and spinal cord injuries are a traumatic pathology commonly encountered in road accidents. The severity of the posttraumatic consequences is given by the magnitude of the meningo-medullary injuries and it is directly proportional to them. Material and Method: A retrospective study on living persons of Bihor County was conducted at the Bihor County Forensic Service, Romania. It consisted of examining forensic documents regarding vertebro-medullary trauma caused by road accidents from the Bihor County Forensic Service archive during 2013-2015. After classifying the descriptive parameters, the obtained data was statistically analyzed and the final results were presented using tables and graphs. Results and Discussions: A quarter of the road accidents occurred in Bihor County during 2013-2015 lead to vertebro-medullary trauma. Mostly, these road accidents occurred in the urban environment, during summer, on Mondays and Sundays, the victims being young male adults. The most exposed category of road traffic participants to spinal trauma is represented by passengers of four-wheeled vehicles (more often driver and the passenger on the right front place) followed by pedestrians. The vertebro-medullary injuries frequently involved the cervical segment, followed by the thoracic and lumbosacral segments, the spine having more frequently a unique lesion. The most noticed mechanism of lesions encountered is hyperextension/hyperflexia. Only one third of the study group had lesions of low intensity, the other cases being of medium or high severity with less or more sever neurological and vegetative symptoms associated. Conclusions: Vertebro-medullary trauma is a major cause of tetraparesis and paraplegia, representing a public health issue. Correct and prompt diagnosis of spinal cord injuries is essential for a favorable prognosis. It is necessary to improve the measures of preventing road accidents.