An Investigation of the Etiology and Pattern of Spinal Injuries Among Patients Presenting to the Emergency Department in a Tertiary Care Hospital

Background Spinal cord injuries contribute substantially to morbidity and mortality globally. There is a gross disparity in the causes of spinal injuries between developed and developing countries. Thus, understanding the etiology and pattern of spinal injury in our setting is important to plan strategies for effective management and prevention strategies at the national level. Methodology A prospective observational study was conducted among 75 patients with spinal cord injury visiting the Department of Emergency Medicine of a tertiary care hospital. The study aimed to investigate the etiology, clinical profile, radiological features, neurological outcomes, and short-term prognosis of patients presenting with acute spinal injuries, focusing on both traumatic and non-traumatic etiologies. A structured questionnaire was used to collect patient information and document the clinical findings. X-ray and CT spine were also performed to understand the type of injury. Results The mean age of 75 patients with spinal injury was 36.4 ± 8.7 years, with 41 (54.7%) males. Road traffic accident was the most common cause seen among 37 (49.3%) cases of injury, followed by falls among 20 (26.7%) cases. Based on the Canadian C-spine rule, a high-risk mechanism of injury was seen among 67 (89.3%) cases. Cervical spine injury was seen among 30 (40.0%) cases, while thoracic and lumbar spines were involved in 26 (34.7%) and 19 (25.3%) cases, respectively. The common neurological presentation was bilateral lower limb weakness, reported in 27 (36%) cases, with combined upper and lower limb weakness seen in 16 (21.3%), and quadriplegia occurred in 6 (8%) cases. Of the 75 patients, 42 (56%) underwent surgical treatment, while 33 (44%) were managed conservatively. Mortality was seen among 20 (26.7%) cases. Common complications included pressure ulcers in 11 (14.7%) cases, with 10 (13.3%) cases each of deep vein thrombosis, urinary tract infection, and pneumonia. Conclusions Spinal trauma was predominantly caused by road traffic accidents and falls. A significant proportion presented with neurological deficits, most commonly incomplete injuries. Surgical management demonstrated neurological improvement in selected cases. The study emphasizes the importance of early mobilization and the need for multidisciplinary care.