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Yang, Shim, Kim, Moon, Sohn, Hong, Nah, Cha, and Joo: Epidemiology of the Spinal Cord and Cauda Equina Injury in Korea -Multicenter Study-
Original Article

Journal of Korean Spine Surg 2011;18(3):83-90.

Published online: 21 September 2011

DOI: https://doi.org/10.4184/jkss.2011.18.3.83

Epidemiology of the Spinal Cord and Cauda Equina Injury in Korea -Multicenter Study-

Jun-Young Yang, M.D., Dae-Moo Shim, M.D.∗, Tae-Kyun Kim, M.D.∗, Eun-Su Moon, M.D.†, Hong- Moon Sohn, M.D.‡, Chang-Hwa Hong, M.D.∮, Ki-Ho Nah, M.D.∥, Soo-Min Cha, M.D., Yong-Bum Joo, M.D.

Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Daejeon

∗Department of Orthopaedic Surgery, School of Medicine, Wonkwang University Hospital, Iksan

†Department of Orthopaedic Surgery, College of Medicine, Yonsei University, Seoul

‡Department of Orthopaedic Surgery, College of Medicine, Chosun University, Gwangju

∮Department of Orthopedic Surgery, Soonchunhyang University College of Medicine, Cheonan

∥Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea

Corresponding author: Jun-Young Yang, M.D. Department of Orthopaedic Surgery, Chungnam National University, School of Medicine, 640, Daesa-dong, Jung-gu Daejeon, Korea TEL: 82-42-220-7351, FAX: 82-42-252-7098 E-mail: jyyang@cnu.ac.kr

Received 27 September 2010       Revised 7 April 2011       Accepted 16 May 2011

Copyright © 2011 Korean Society of Spine Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

Multicenter study, questionnaire survey.

Objectives

To offer a database of spinal cord injury (SCI) by reviewing statistics and literatures of other countries, investigating the overall mechanism, injury patterns and treatment of SCI.

Summary of Literature Review

There are no preexisting domestic studies (collectively conducted by multicenters) of the prevalence and treatment of SCI.

Materials and Methods

From September 2006 to August 2009, 47 cases of SCI in 6 universities were investigated retrospectively. 17 questionnaire contents including the courses of injury-to-treatment were studied with data gathered from surveys.

Results

The average age of patients was 48.4-years-old, male to female ratio was 33 to 14. The cases of falling from a height were 22 cases (47%), lumbar area 19 cases (40%), and unstable bursting fracture 24 cases (51%) the most. Complete and incomplete paralyses were 19 cases (40%) and 28 cases (60%), respectively. High dose steroids were injected in 16 cases (NASCIS II) and 9 cases (NASCIS III). 14 cases presented complications and operations were performed 46 cases (98%). 12 cases (26%) arrived at the hospital within 4 hours of injury, 11 cases (23%) in 8 hours. On the way to the hospital, proper emergency treatment was performed in 25 cases (53%), and 30 cases (64%) had a clear understanding of SCI after the final diagnosis.

Conclusions

This is the first study that offers a comprehensive database of spinal cord injury (SCI), by investigating the overall mechanism, injury patterns, and treatment of SCI; this study is expected to be used in the future as an important reference material for spinal cord injury statistics and a standard for care.

Keywords: Spinal cord injury, Multicenter study, Prevalence

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Figures and Tables%

Fig. 1.
Multicenter study, questionnaire survey. 17 contents asked of 6 university spine surgeons.
jkss-18-83f1.tif
Table 1.
Summary of cases of spinal cord injury
No Sex Age Injury mechanism* Arrival time Level† Diagnosis‡ Neurology ASIA scale MP injection Treatment Complication
1 M 19 FFH ~ 4 hrs Cervical Fx & DL Complete A ~ 3 hrs Op ~ 8 hrs
2 F 22 TA 24 hrs ~ Cervical Etc Complete A No record Op 48 hrs ~
3 M 25 TA 24 hrs ~ T+L Bursting Incomplete C No injection Op 8~24 hrs Respiratory
4 M 27 FFH 24 hrs ~ C+T+L Bursting Complete A No injection Op 48 hrs ~
5 M 29 FFH ~ 4 hrs Lumbar Bursting Incomplete D 3~8 hrs Op 8~24 hrs
6 F 29 TA 24 hrs ~ T+L Bursting Incomplete C No injection Op 48 hrs ~
7 M 30 FFH 24 hrs ~ Lumbar Etc Incomplete B No injection Op ~ 8 hrs Sore
8 M 31 Postop ~ 4 hrs Cervical Fx & DL Complete A ~ 3 hrs Op 48 hrs ~
9 M 33 FFH ~ 4 hrs T+L Fx & DL Complete A 3~8 hrs Op 48 hrs ~
10 M 37 TA 24 hrs ~ Lumbar Bursting Incomplete D No injection Op 48 hrs ~
11 F 38 TA ~ 4 hrs Cervical Fx & DL Complete A ~ 3 hrs Op 48 hrs ~
12 F 38 Slip down 24 hrs ~ Thoracic Bursting Incomplete C No injection Op 8~24 hrs
13 M 40 Postop 4~8 hrs Thoracic Fx & DL Incomplete B No injection Op 8~24 hrs
14 M 41 Slip down 24 hrs ~ C+T+L Bursting Incomplete B No injection Op 48 hrs ~ Respiratory
15 M 42 FFH 4~8 hrs T+L Fx & DL Complete A 8~24 hrs Op 48 hrs ~
16 F 42 TA ~ 4 hrs Lumbar Etc Incomplete C ~ 3 hrs Op 8~24 hrs GI bleeding
17 M 43 FFH 24 hrs ~ Lumbar Bursting Incomplete D No injection Op 8~24 hrs
18 M 43 FFH 24 hrs ~ Thoracic Bursting Incomplete B No injection Op 8~24 hrs
19 F 43 FFH 24 hrs ~ Lumbar Bursting Incomplete D No injection Op 48 hrs ~
20 M 44 TA 4~8 hrs T+L Fx & DL Complete A 8~24 hrs Op ~ 8 hrs
21 M 44 TA 24 hrs ~ Lumbar Fx & DL Complete A No record Op 8~24 hrs
22 M 46 FFH 4~8 hrs Cervical Fx & DL Incomplete D 3~8 hrs Op 48 hrs ~ Sore
23 M 47 FFH 8~24 hrs Lumbar Bursting Incomplete D No injection Op 48 hrs ~
24 M 49 FFH 4~8 hrs Thoracic Bursting Incomplete C 3~8 hrs Op 48 hrs ~
25 M 49 Slip down 4~8 hrs T+L Etc Incomplete D No injection Op 24~48 hrs
26 F 49 FFH 4~8 hrs Lumbar Bursting Incomplete E No injection Op ~ 8 hrs
27 F 49 FFH 8~24 hrs T+L Bursting Incomplete C No injection Op ~ 8 hrs Sore
28 M 50 TA ~ 4 hrs Lumbar Fx & DL Complete A No injection Op 8~24 hrs
29 M 51 Direct injury 4~8 hrs Lumbar Bursting Incomplete B No record Op 48 hrs ~
30 F 52 TA 24 hrs ~ T+L Etc Complete A No record Op 48 hrs ~
31 F 55 FFH 24 hrs ~ Lumbar Etc Incomplete C No injection Op 48 hrs ~
32 M 56 FFH 8~24 hrs Lumbar Bursting Complete A 8~24 hrs Op 48 hrs ~ Respiratory
33 M 57 TA 8~24 hrs T+L Etc Complete A 8~24 hrs Op 8~24 hrs
34 F 57 FFH 4~8 hrs T+L Etc Complete A 8~24 hrs Op 8~24 hrs UTI
35 F 57 Slip down 24 hrs ~ Cervical Etc Incomplete E No injection Op 8~24 hrs
36 M 58 Slip down ~ 4 hrs Cervical Fx & DL Complete A ~ 3 hrs Op 8~24 hrs Sore
37 M 58 FFH ~ 4 hrs C+T+L Fx & DL Complete A ~ 3 hrs Op ~ 8 hrs Respiratory
38 F 58 TA 4~8 hrs Lumbar Bursting Incomplete C 3~8 hrs Op 48 hrs ~ DVT
39 M 62 FFH 4~8 hrs C+T+L Bursting Complete A 8~24 hrs Op 8~24 hrs
40 M 63 TA 24 hrs ~ Lumbar Bursting Incomplete D No record Op 8~24 hrs Sore
41 M 67 FFH ~ 4 hrs Thoracic Bursting Incomplete D ~ 3 hrs Op 48 hrs ~
42 M 67 FFH 24 hrs ~ Lumbar Etc Complete A No injection Op 48 hrs ~ Respiratory
43 F 67 TA ~ 4 hrs Lumbar Bursting Complete A ~ 3 hrs Op 48 hrs ~
44 M 71 Indirect injury ~ 4 hrs T+L Bursting Incomplete C ~ 3 hrs Op 24~48 hrs
45 M 76 Slip down 24 hrs ~ Lumbar Bursting Incomplete D No injection Conservative
46 M 78 FFH 24 hrs ~ Lumbar Bursting Incomplete D No injection Op 48 hrs ~ UTI
47 M 86 TA 8~24 hrs C+T+L Etc Incomplete D No injection Op 24~48 hrs

* FFH: Fall from height injury, TA: Traffic accident

† C: Cervical, T: Thoracic, L: Lumbar,

‡ Fx: Fracture, DL: Dislocation

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