Epidemiologic profile of surgery for spinomedullary injury at a referral hospital in a country town of Brazil

Objectives: To analyze the epidemiological profile of patients undergoing surgery at a referral hospital in a small, country town. Methods: A retrospective study was carried out between February 2009 and May 2010, in a Regional Referral unit, with a total of 24 patients. The cases study included all patients undergoing surgery for spinal trauma during this period, with or without neurological deficits. The data analyzed were: sex, age, location and degree of the injury, and mechanism of the injury. Results: The medianage of the patients was 35.8 years, and 75% were male. The mechanisms of the injury were motorcycle accidents in 37.5%, falls in 33.3%, automobile accidents in 25%, and diving into shallow water in 4.2%. The vertebral level affected was the cervical spine in 44%, the thoracic spine in 36%, and the thoracolumbar level in 20%. The neurological damage, classified according ASIA (American Spinal Injury Association) was complete, or category A in 37.5%, incomplete, or category B in 4.2%, incomplete, or category C in 12.5%, incomplete, or category D in 8.3%, and incomplete, or category E in 37.5%. In terms of access route, 64% of the procedures were performed with posterior access and 36% with anterior access. Conclusion: The epidemiological profile maintains the trend towards a prevalence of injuries among young men, affecting the cervical level, with the presence of spinal cord lesion. However, accidents involving motorcycles and fallings from heights are factors that can be modified by safety measures on the roads and in the workplace, which can reverse the high prevalence of these accidents.

研究目的：分析某小型乡镇转诊医院手术患者的流行病学特征。
研究方法：本研究为回顾性研究，于2009年2月至2010年5月在区域转诊中心开展，共纳入24例患者。研究对象为该时段内所有因脊柱创伤接受手术的患者，伴或不伴神经功能缺损。本次分析纳入的数据包括：性别、年龄、损伤部位与损伤程度，以及损伤发生机制。
研究结果：患者中位年龄为35.8岁，其中75%为男性。损伤发生机制分别为：摩托车事故占37.5%，跌倒占33.3%，汽车事故占25%，浅水跳水占4.2%。受累椎体节段分布为：颈椎占44%，胸椎占36%，胸腰段占20%。神经损伤按美国脊柱损伤协会（American Spinal Injury Association, ASIA）标准分级：完全性损伤（A级）占37.5%，不完全性损伤B级占4.2%，C级占12.5%，D级占8.3%，E级占37.5%。手术入路方面，64%的手术采用后路入路，36%采用前路入路。
研究结论：本次研究的流行病学特征显示，年轻男性脊柱创伤患病率仍处于较高水平，受累节段以颈椎为主，且多伴随脊髓损伤。然而，摩托车事故及高处坠落这类损伤可通过道路与职场安全防控措施加以干预，从而有效降低此类事故的高发生率。