Neglected thoraco lumbar traumatic spine injuries

Abstract

Study Design: Retrospective study.Purpose: To outline the etiology, complications and management difficulties encountered in the management of neglected thoracolumbarspine injuries.Overview of Literature: The English literature describes overlooked diagnosis as the most common cause of neglected spineinjuries. However, the reasons differ in developing or under-developed nations. Moreover, there is scarcity of literature about the neglectedspinal injuries.Methods: Patients presenting with thoracolumbar traumatic injuries who had not received any form of treatment for more than threeweeks were included in the study. The demographic details, operative procedure performed and complications encountered, alongwith American Spinal Injury Association grade and spinal cord independence measure score recorded on the history sheets werenoted. The data were analyzed.Results: Forty patients were included in the study. Inadequate treatment at the first contact hospital (45%) followed by late presentation(38%) and missed injury (17%) were the major etiological factors for the neglected traumatic injuries in the thoracolumbar spine.The most common complications seen in the management of these cases were pressure sores (58%), back pain (57%), urinary tractinfection (42%) and residual kyphotic deformity (42%).Conclusions: Management of neglected thoracolumbar injuries is challenging. The delay in presentation should not prevent spinesurgeon in proceeding with operative intervention as good results can be expected.