An Epidemiological Overview of Spinal Trauma in the Kingdom of Saudi Arabia

Abstract

The World Report on Road Traffic Injury Prevention indicates that by 2020, road traffic injuries will be a major killer, accounting for half a million deaths and 15 million disability-adjusted life years. The Kingdom of Saudi Arabia (KSA) has one of the highest rates of spinal cord injuries in the world, with 62 people injured per 1 million, and the injuries are mostly due to traffic accidents. Materials and Methods:All polytrauma patients associated with spinal injuries admitted to Prince Mohammed bin Abdul Aziz Hospital (PMAH), Riyadh, from January 2017 to June 2018, were included in this study. Patients with old spinal injuries, any previous spinal surgery, spine infection, or concomitant diagnosed malignancies or osteoporotic collapse with or without falls were excluded. All patients underwent whole-spine computed tomography scan and, in selective cases, magnetic resonance imaging of the spine. Results:Of the 230 patients, 90.0% were male, and 60% were in the second and third decades.Motor vehicle accidents were responsible for 83% of the cases, of which 50% of the victims were the drivers, and 80% were passengers with no seatbelt on. Nearly 50% of the spinal injuries were associated with injuries in the other body parts. Cervical spine injury accounted for 44% of the cases, followed by the lumbar spine injury. Twenty five percent of the patients presented with fixed neurologic deficit in the form of quadriplegia or paraplegia (ASIA-A). The mortality rate was 1.3%. Conclusion:This study revealed that motor vehicle accidents are a major cause of spinal injuries in the KSA. One-fourth of the spinal Injuries are associated with complete spinal cord injuries. Therefore, in order to prevent lifelong disability in the young population, a nationwide program should be initiated to prevent road traffic accidents.

Pattern and In-Hospital Mortality of Thoracoabdominal Injuries Associated with Motor Vehicle Accident-Related Spinal Injury: A Retrospective Single-Center Study

“…This is consistent with most studies on MVA-related TSI [ 25 ]. The very high male percentage reported here is coherent with other studies from Saudi Arabia [ 21 , 26 ]. The explanation is likely cultural and legislative factors, including a previous pan on women driving, rather than anatomical or physiological factors [ 15 ].…”

“…Patients in the 20–40 years age group were the most affected in our study. This is similar to results from local and regional studies on MVA-related TSI [ 2 , 21 ]. Globally, the mean age of TSI is 40 years, with a tendency to increase in developed countries while decreasing in low-income nations [ 19 ].…”

“…The presence of associated injuries is a plausible contributing factor for several reasons. Firstly, coexistent nonspinal injuries are present in over half of the TSI patients [ 21 – 23 ]. Secondly, the presence of TSI increases the odd of concomitant thoracoabdominal injuries by several folds [ 20 , 24 ].…”

Epidemiology, trend and in-hospital outcome of traumatic spinal injuries due to road traffic accidents

“…Though rare, traumatic spinal injuries have significant potential to cause death and devastating disability with an enormous burden on the individual, caregiver, and the healthcare system. 1,5 Polytraumatized patients with TSI have higher mortality and more unsatisfactory outcome compared to patients with no spinal injury. [6][7][8][9][10][11][12][13][14] The rate of TSI in Saudi Arabia is one of the highest globally (62 TSI per million), with RTA being the primary mechanism of injury.…”

An Overview on Road Traffic Accident Management Approach

“…In Saudi Arabia, these motor accidents were responsible for fourthfifths of spinal traumas. [11] In addition to spinal trauma, the soft-tissue injury could manifest as herniated vertebral discs or variable nerve injury. This could often be missed in a patient without neck protection or inclusion of back examination in the trauma survey and examination.…”