Study design: Retrospective study. Objective: To evaluate the epidemiology and treatment outcome of spinal cord injuries (SCIs) at three tertiary care centres within southeast Nigeria. Setting: Southeast Nigeria. Methods: Causes, seasonal variation, transportation to hospital, severity of injury, treatment and outcome of patients with SCIs treated by the authors at three study locations from September 2009 to August 2012 were studied. Results: Eighty-five patients with SCI had been admitted during that period to the three hospitals and were qualified for the study. The age range was 2-75 years with a mean of 36.13 years. The 31-45 years age group is the most frequently affected. Altogether, 69 male and 16 female individuals were involved. Motor vehicle accident (MVA) (47, 55.3%) was the most frequent cause of injury. Falls from palm trees (3.5%) were markedly reduced from what they were inferred to be (40.2%) from a similar study in our area in 1988. Injury peaks were observed during major festivities. Only three patients (0.035%) were transported to care centres with an ambulance. Forty patients were classified as being affected by ASIA grade A injury, whereas 45 patients had various ASIA grades of incomplete injury. Sixty-eight patients were managed conservatively; 23 of them improved from their grades, 35 remained the same, 1 worsened, while 9 died. Of 17 patients treated operatively, 9 improved, 5 remained the same, 2 worsened and 1 died. Conclusion: Currently, SCIs reported in the three main hospitals located in southeast Nigeria are caused mainly by MVAs. SCI affects mainly male individuals and peak frequencies are observed during festivities.

Lacerations and fractures were the most common injuries. RTA was the leading cause of injury. TBI was the most common cause of injury-related death.

Study design: Description of 12-week programme of treatment. Objectives: In Enugu, Nigeria, not all spinal injured (SCI) can be treated in teaching and orthopaedic hospitals. The 12-week programme was developed with the aim of getting such patients back into society as useful and independent as possible, using the patients relations to complement the de®ciency in personnel. Setting: Enugu, Nigeria. Methods: Staged weekly programmes of assessment and treatment were mapped out to end at the twelfth week. Spinal injured patients of less than 2 weeks duration were entered into these programmes as they presented. Outcome was assessed at the end of the twelfth week. The study lasted for 6 years (January 1996 to December 2000). Results: Seventy-four patients were admitted into the study. Nine patients had incomplete cord injury of Frankel C while 65 had clinically complete injury of Frankel A on admission. Eight of the nine incomplete injuries improved to Frankel D and walked home within the 12-week programme. In the clinically complete group, eight died. Out of the 57 remaining, six recovered to Frankel D and walked home, while the remaining 51 who did not recover, 49 were conversant with wheelchair use within the 12-week programme. Conclusion: It is concluded that adoption of this programme would allow the spinal cord injured to get expert treatment within a reasonable time in less ideal hospital settings where man-power and skilled members of the spinal cord injury treatment team are lacking.

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