Long-Term Complications of Chronic Traumatic Paraplegia: An Experience from Pakistan

Abstract

OBJECTIVE: This study was conducted to ascertain the long-term complications of chronic traumatic paraplegia and the quality of life of paraplegic patients. Study Design: A retrospective descriptive study. PLACE AND DURATION OF STUDY: Conducted at Fauji Foundation Hospital, Rawalpindi, Pakistan. MATERIALS AND METHODS: Twenty-six admitted male patients suffering from traumatic paraplegia were physically and neurologically examined, and the available laboratory and radiological investigations were done. The medical records of all patients were thoroughly reviewed. RESULTS: Falls were found to be the most common cause of the paraplegia (57.7%). Neurological recovery did not occur in any patient, even after three decades. All patients had developed complications of urinary tract infections, such as chronic renal failure, renal/ bladder stones, and epidydimo-orchitis. Urinalysis showed asymptomatic bacteriuria in all patients. Urine culture showed Pseudomonas Aeruginosa in 65.3% and E. Coli in 42.3% of samples. Multiple uropathogens were present in 77.9% of cases. Persistent and recurrent bed sores were present in 46.1% patients. Many patients had episodic, burning leg pain, spasticity of legs (76.9%), and contractures of knee joints. All patients were irritable, depressed, and had suicidal ideas. CONCLUSIONS: This study showed that traumatic paraplegia is a permanent disability. It is associated with high morbidity rate due to scores of complications, particularly recurrent urinary tract infections and pressure sores. Prevention, early detection, and timely intervention of potential complications are of the utmost importance.