Demography, Diagnosis and Complications of Spinal Cord Injury Patients in a Rehabilitation Center of Bangladesh

Abstract

IntroductionSpinal cord injury, is certainly a debilitating and devastating condition in terms of its effect on a person`s physical, mental, familial as well as social life [1]. Due to its profound impact on a person`s overall quality of life and increasingly high incidence, injury to spinal cord due to any pathology is now considered as a morbid condition as well as a threat to both personal and national economy [2,3]. Spinal cord injury itself is a crippling condition, at the same time may lead to a variety of complications which can affect the life of the patient as it increases the treatment cost significantly and accelerate the disease process which link to early mortality [1,3,4]. The incidence of Spinal cord injury is increasing throughout the world with an annual incidence rate of 15 to 40 per million with a male predominance, more prevalence in low socio-economic society and the causes ranges from traumatic in most of the case like motor vehicle accident to gunshot injury and physical violence, however non traumatic causes like Tuberculosis (TB) of the spine is also responsible for this [3][4][5][6]. A great variety of complications usually follow injury to spinal cord such as pressure sore, urinary complications, most of which are preventable nonetheless these associated complications are the most common cause of re-hospitalization following spinal cord injury and eventually lead to a great deal of disability, morbidity, degree of dependence and mortality [1][2][3][4].Spinal cord injury is a severe condition of the musculoskeletal system, more often leading to permanent disability and on the top of that brings about drastic changes the functioning ability of the patient and eventually encompassing each and every aspect of life [5][6][7][8]. Complications may associate virtually all systems of the body namely cardio-respiratory system, genitourinary system, local disorders like pressure sore or full blown biochemical disorders. Such domino effect following the injury to spinal cord significantly decreases the quality of life of the individual and happens on the early or acute stage when initial rehabilitation process are being initiated [6]. Spinal cord injury whether traumatic or form other cause and AbstractBackground: Spinal cord injury and its health related complications pose a major impact on the overall morbidity and mortality as well as cause economic constrains. It was aimed at looking into the demographic distribution, diagnosis, as well as complications in patients with spinal cord injury.

Epidemiology of Spinal Cord Injury in Bangladesh: A Five Year Observation from a Rehabilitation Center

“…The incidence of spinal cord injury is increasing with time with an annual rate of 15-40 cases per million [2,5,7] with male predominance and a propensity of affecting the low-socio economic group [2]. The condition leads not only to varying degrees of physical disabilities including paralysis, sensory deficit, dysfunction of bowel and bladder [3,4,8,9] but also to various crippling complications such as pressure sore, autonomic dysreflexia, deep vein thrombosis, spasticity, sexual dysfunction and pneumonia [2,4,8]. On top of that, spinal cord injury poses grave impact over the economy both personal and national, as the condition itself as well as the complications lead to significant increase of cost [2,10].…”

“…Spinal Cord injury, whether traumatic or non-traumatic, is a sudden [1], devastating and debilitating [2][3][4] neurological condition [5] addressed throughout the history [5,6]. The incidence of spinal cord injury is increasing with time with an annual rate of 15-40 cases per million [2,5,7] with male predominance and a propensity of affecting the low-socio economic group [2].…”

“…The condition leads not only to varying degrees of physical disabilities including paralysis, sensory deficit, dysfunction of bowel and bladder [3,4,8,9] but also to various crippling complications such as pressure sore, autonomic dysreflexia, deep vein thrombosis, spasticity, sexual dysfunction and pneumonia [2,4,8]. On top of that, spinal cord injury poses grave impact over the economy both personal and national, as the condition itself as well as the complications lead to significant increase of cost [2,10]. Moreover, the psychological effects of spinal cord injury create burden for the patient as well as family members and also for the society [8].…”

“…Fall from height, road traffic accident, gunshot injury, sports injury is so far identified to the leading cause of injury around the world [2,4,5,10] and spinal tumor, tuberculosis(TB), transverse myelitis(TM) seems to the principle nontraumatic cause [2,5,6,9]. American Spinal Injury Association (ASIA) impairment score has been used for measuring the extent of injury and level of impairment varies from paraplegia to tetraplegia [10][11][12].…”

“…Bangladesh, a poor but developing country of south-asia [13] suffers a great deal of socio-economic problem arising from spinal cord injury and its health-related complications as evident from the yearly rate of admission at the specialized center like Centre for Rehabilitation of the Paralyzed (CRP) [2,[14][15][16]. There is scarcity of extensive epidemiological data in Bangladesh hence this research aimed to assess the epidemiology of spinal cord injury as a preliminary step towards the prevention of this condition and the related complications.…”