Epidemiology of non-traumatic spinal cord injury in Uganda: a single center, prospective study with MRI evaluation

Abstract

BackgroundA few reliable national data concerning the etiology of non-traumatic spinal cord injury (SCI) in sub-Sahara Africa exists, mainly because of the limitations of diagnostic imaging. These are both expensive and mostly unavailable in several resource-limited settings. Only a few studies have employed the magnetic resonance imaging (MRI) in documenting non-traumatic SCI and most of these studies are from South Africa. We sought to describe the clinical presentation, MRI radiological patterns, and one-year survival among subjects with non-traumatic SCI in Uganda.MethodsWe enrolled a prospective cohort of 103 participants with non-traumatic SCI at Mulago National Referral Hospital Kampala, Uganda in 2013–2015. Participants received standard of care management, with surgical intervention as needed, with one-year follow up. Data were analyzed using Descriptive statistics.ResultsIn 103 participants with non-traumatic SCI, the median (IQR) age was 37 (18, 85) years and 25% of the participants were HIV-infected. Paraplegia/paraparesis was the most common clinical presentation in 70% (n = 72). Severe disease was present in 82% (n = 85) as per American Spinal Injury Association (ASIA) scale A-C. On MRI, 50% had extradural lesions. However, bone lesions accounted for only 75% of all the extradural lesions. More than 60% of the patients had lesions that could only be diagnosed on MRI. Deaths occurred in 42% (n = 44) of participants, with the highest mortality among those with extradural lesions (60%).ConclusionThe mortality following non-traumatic spinal cord injuries in Uganda is high. We demonstrated an equal distribution between extradural and intradural lesions, which differs from the historical predominance of extradural lesions. Increased utilization of MRI particularly among young age groups is needed to make a diagnosis.Electronic supplementary materialThe online version of this article (10.1186/s12883-019-1236-3) contains supplementary material, which is available to authorized users.

Neurological Impairment Recovery in Surgically Treated Patients With Nontraumatic Spinal Cord Injury

“…Contrarily, other studies showed that both sexes were affected equally. 6 , 11 In addition, the mean age in our study was 61 years, which is a similar finding in many previous studies with a mean age between 40 and 62 years. 7 , 11 , 12 All in all, there was no statistical significance in sex and age with the neurological outcome.…”

“… 3 - 5 The most described NTSCI causes are degenerative disk disease and spinal canal stenosis, tumors, vascular diseases, and inflammatory conditions. 4 - 6 The incidence of NTSCI is reported to be higher than that of traumatic spinal cord injury in many countries, making it an area of growing significance. 7 , 8 However, the prevalence of studies on NTSCI has not been widely reported and is lacking.…”

The Integrated Transcriptome Bioinformatics Analysis Identifies Key Genes and Cellular Components for Spinal Cord Injury-Related Neuropathic Pain

“…Spinal cord injury, one of the most devastating diseases, disrupts communication between the central and peripheral nervous, leading to the loss of essential neurological functions. Due to a large number of traffic and industrial accidents, the incidence rate of SCI is increasing rapidly around the world (Azarhomayoun et al, 2018;Musubire et al, 2019). Chronic phase of SCI may last a long period after the acute phase, which bring physically and psychologically devastating traumas to persons with SCI (Budh and Osteraker, 2007).…”

“…Therapeutically, there are no effective treatment strategies for SCI-induced neurological deficits, leading to a high disability rate and adding heavy burdens to the individual family and the whole society. In order to bring tangible benefits to patients with SCI, there is a pressing need to explore the pathologic mechanisms which may provide candidate targets for treatment (Azarhomayoun et al, 2018;Musubire et al, 2019).…”

Clinical Presentation and Causes of Non-traumatic Spinal Cord Injury: An Observational Study in Emergency Patients

“…It is defined as any damage to the spinal cord resulting from a non-traumatic cause (3). Etiologies include degenerative, inflammatory, neoplastic and infectious conditions (1,(4)(5)(6).…”