LONG TERM FOLLOW UP AFTER SPINAL CORD INJURY: CASE SERIES FROM A TERTIARY CARE CENTRE OF NORTH INDIA
Abstract
Study design: Prospective observational case series study.
Objectives: To find out the outcomes in long term follow-up after Spinal Cord Injury
Setting: Sawai Man Singh Medical College and Hospital, Jaipur, India.
Methods: Consecutive Long term follow up (more than one year) of SCI cases from 2000 to 2006 were evaluated on a preformed proforma for
outcomes.
Results: Out of 1819 cases of SCI, 198 (11.1%) [97 cervical (10%) and 101 DL (12%)] cases reported for follow-up of 1 year or beyond, with male
to woman ratio of 6.9:1 and 86% in the age group of 20–59 years. The mean follow up period was 27 months with a range 12 to 78 months. There is
no change in AIS grading in most of the cases (116 out of 198). Most of the cases (73 cervical and 84 DL) were independent in bed mobility, where
as more cervical cases were independent for transfers and community ambulators in comparison to DL SCI. DL SCI improves better in aspect of
ADL. For bladder management, cervical SCI patients should avoid reflex emptying and Foley's catheterisation and DL SCI cases should do timely
self intermittent clean catheterisation technique and follow adequate fluid restriction. For bowel management, they should be counselled to avoid
constipation to prevent other complications such as piles etc. For better sexual experience in SCI cases, it is advised to counsel the patients to
attempt conversion of active partner to be the spouse. For psychological management, efforts should be made to counsel patients and caregivers to
avoid depression. The role of vocational training and initial financial support needs to be emphasized
Conclusion: Since there is a paucity of studies on the long term follow-up after SCI from India as well as around the world, it is emphasized that
such multiple studies on long term follow-up after SCI should be carried out at multi-centric level across various countries and continents all over
the world. The results of these studies can be compared with each other to give a different perspective on the management of SCI. It will lead to
better outcomes in long term follow-up in SCI cases. All these efforts will help in successfully reintegrating SCI patients into the community
Keywords
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