Iatrogenic spinal cord injury - reality in Alcoitão’s Center
DOI:
https://doi.org/10.25759/spmfr.37Abstract
Objectives: Spinal cord injury (SCI) has several causes, not only iatrogenic, but also traumatic, vascular, neoplasic,infectious, degenerative, metabolic and congenital. The true relative contribution of each cause in the incidenceof this disease on a global scale is unknown. We found only one retrospective study (Bacher et al.) whichconsidered the incidence of iatrogenic SCI in a Rehabilitation Centre and characterized its population. The aimsof the present study were to quantify the incidence and characterize iatrogenic SCI of an inpatient population inthe Centro de Medicina de Reabilitação do Alcoitão (CMRA) and to compare the results with the mentionedstudy.
Methods: Longitudinal retrospective study of patients admitted for the first time to the SCI department of CMRAin a 5 year period. Demographic and clinical data were collected from the clinical file of these patients. The sample included 16 patients. The incidence of iatrogenic SCI was determined between 1-1-2005 e 31-12-2008(n=11). For the characterization of iatrogenic SCI, inpatients from 1-7-2004 e 30-6-2009 were accepted (n=16).
Results: We obtained an incidence of iatrogenic injury of 2,7%. The mean age was 58 years, with slight femalepredominance. The most frequent pre-iatrogenic diagnosis was degenerative spondylopathy (53,3%). In 50% theiatrogenic medical act was spinal surgery (62,5% lumbar surgery) being laminectomy the most common surgicalprocedure. Most cases were classified as paraplegia ASIA B (31,2%) or ASIA C (37,5%), with thoracic neurologicallevel in 56,2% of the patients. In 54,5%, the index event occurred immediately after the surgery. The study ofBacher et al. revealed a lower incidence of iatrogenic lesion (0,69%) and the majority of patients were classifiedas paraplegia ASIA A.
Conclusion: The incidence of iatrogenic SCI is still not well understood. The comparison between the two studiesshowed important differences of incidence, but a relatively similar clinical description. More studies, specially witha multicenter design, are needed for a better characterization of iatrogenic SCI.
Keywords: Spinal Cord Injuries; Iatrogenic Disease; Epidemiology.
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