Summary
During the period 1968–1975, 11 patients with paraplegia and 19 with tetraplegia were treated at the Central Hospital of Tampere. The mean age of the patients was 33 years. The spinal cord injury was sustained in a traffic accident in 11 cases, at work in 6 and at home or during leisure hours in 13. The injury was due to a fall or to hitting the bottom in diving in 17 cases. Reduction and osteosynthesis (Williams) were performed on 4 paraplegic patients. The tetraplegics were treated by skull traction and an orthopedic brace. The average duration of primary hospital treatment was 69 days for the paraplegics and 72 days for the tetraplegics. Tracheostomy was performed on 7 tetraplegic patients. Tracheal stricture, which developed in 2 cases, was conservatively treated. A catheter à demeure was applied primarily in all cases, and urinary infection developed in all patients. Four paraplegics and 4 tetraplegics developed deep venous thrombosis, which led to pulmonary embolism in 1 paraplegic and 2 tetraplegic patients. All these patients recovered. During primary hospital treatment 3 paraplegics and 5 tetraplegics developed bed sores, which were operatively treated in 4 cases. Two paraplegic and 8 tetraplegic patients died during primary hospital treatment; three of these patients had also sustained a severe brain injury. In addition, 1 paraplegic and 2 tetraplegic patients died of pulmonary infection during the five-year follow-up period. At the time of follow-up examination 7 paraplegics were nursed at home and l was in institutional care; the corresponding figures for the tetraplegics were 3 and 6. Five of the paraplegics were ambulant in a wheel-chair, 2 walked with the aid of crutches, and 1 was a bed-patient. Of the tetraplegics, 6 were ambulant in a wheel-chair and 3 were nursed in bed. All surviving patients, 1 paraplegic excepted, had a disability pension.
Zusammenfassung
Im Zentral-Krankenhaus Tampere wurden in den Jahren 1968–1975 11 Patienten mit Paraplegie und 19 mit Tetraplegie behandelt. Das Durchschnittsalter der Patienten betrug 33 Jahre. Eine Verletzung der Medulla ereignete sich im Straßen-verkehr bei 11 Patienten, durch Arbeitsunfälle in 6 und zu Hause oder in der Freizeit in 13 Fällen. Fallen oder Tauchen war in 17 Fällen die Ursache der Verletzung. Bei 4 Paraplegikern wurden Reposition und Osteosynthese (Williams) durchgeführt. Die Tetraplegiker wurden mit Dauerzug und Stützkorsett behandelt. Die primäre stationäre Behandlung der Paraplegiker betrug im Durchschnitt 69 Tage, die der Tetraplegiker 72 Tage. Eine Tracheostomie wurde bei 7 Tetraplegikern durchgefuhrt; davon bekamen 2 eine Tracheastriktur,die konservativ behandelt wurde. Alle Patienten hatten von Anfang an einen Dauerkatheter, und bei allen entstand eine Harnwegsinfektion. Bei je 4 Paraplegikern und Tetraplegikern entstand eine tiefe venöse Thrombose, die bei einem Paraplegiker und 2 Tetraplegikern zu Lungenembolien führte. Die Lungenemboliepatienten erholten sich. Während der primären stationdren Behandlung entstanden bei 3 Paraplegikern und 5 Tetraplegikern Dekubitalgeschwüre, von denen 4 operativ behandelt wurden. Beim primären Krankenhausaufenthalt starben 2 Paraplegiker und 8 Tetraplegiker. Von den letzteren hatten 3 außerdem einen schweren Hirnschaden. Innerhalb einer Folgezeit von 5 Jahren starben zusätzlich 1 Paraplegiker und 2 Tetraplegiker an einer Lungenentzündung. Bei der Nachuntersuchung befanden sich 7 der Paraplegiker in Hausbetreuung, einer in einer Anstalt, 3 der Tetraplegiker in Hausbetreuung und 6 in einer Anstalt. Fünf Paraplegiker bewegten sich mit Rollstuhl, 2 mit Stöcken, und einer war bettlägerig. Sechs der Tetraplegiker bewegten sich im Rollstuhl, und 3 waren bettlägerig. Eine Rentenzahlung erfolgte wegen Arbeitsunfähigkeit bei allen außer einem Paraplegiker.
Similar content being viewed by others
References
Burke, D. C.: Traumatic spinal paralysis in children. Paraplegia11, 268–276 (1974)
Burke, D. C., Murray, D. D.: The management of thoracic and thoraco-lumbar injuries of the spine with neurological involvement. J. Bone Jt. Surg.57-B, 254 (1975)
Campbell, J., Bonnett, C.: Spinal cord injury in children. Clin. Orthop.112, 114–123 (1975)
Cook, J. B.: The assessment of spinal cord damage and factors influencing rehabilitation and survival. Mod. trends Neurol.4, 165–179 (1967)
Gibbon, N. O. K.: Neurogenic bladder in spinal cord injury. Urol. Clin. N. Amer.1, 147–154 (1974)
Goldberg, R. T., Freed, M. M.: Vocational adjustment, interests, work values, and career plans of persons with spinal cord injuries. Scand. J. Rehabil. Med.5, 3–11 (1973)
Guttmann, L.: Zur Problematik der Wirbelsäulenfrakturen bei Querschnittsläsionen des Rückenmarks. Z. Orthop.112, 911–918 (1974)
Hachen, H. J.: Anticoagulant therapy in patients with spinal cord injury. Paraplegia12, 176–187 (1974)
Härkönen, M., Kataja, M., Lepistö, P., Paakkala, T., Pätiälä, H., Rokkanen, P.: Injuries of the cervical spine. Clinical and radiological results in 119 patients. Arch. Orthop. Traumat. Surg. To be published. (a)
Härkönen, M., Kataja, M., Lepistö, P., Paakkala, T., Pätiälä, H., Rokkanen, P.: Fractures of the thoracic spine. Clinical and radiological results in 98 patients. Arch. Orthop. Traumat. Surg. To be published. (b)
Härkönen, M., Kataja, M., Keski-Nisula, L., Paakkala, T., Pätiälä, H., Rokkanen, P.: Injuries of the thoraco-lumbar junction. Clinical and radiological results in 149 patients. Arch. Orthop. Traumat. Surg. To be published. (c)
Härkönen, M., Kataja, M., Keski-Nisula, L., Paakkala, T., Pätiälä, H., Rokkanen, P.: Fractures of the lumbar spine. Clinical and radiological results in 94 patients. Arch. Orthop. Traumat. Surg. To be published. (d)
Kewalramani, L. S., Taylor, R. G.: Injuries to the cervical spine from diving accidents. J. Trauma15, 130–142 (1975)
Lewis, J., McKibbin, B.: The treatment of unstable fracturedislocations of the thoraco-lumbar spine accompanied by paraplegia. J. Bone Jt. Surg.56-B, 603–612 (1974)
Marar, B. C.: The pattern of neurological damage as an aid to the diagnosis of the mechanism in cervical-spine injuries J. Bone Jt. Surg.56-A, 1648–1654 (1974a)
Marar, B. C.: Hyperextension injuries of the cervical spine. The pathogenesis of damage to the spinal cord. J. Bone Jt. Surg.56-A, 1655–1662 (1974b)
Naso, F.: Pulmonary embolism in acute spinal cord injury. Arch. Phys. Med. Rehabil.55, 275–278 (1974)
Nieminen, R.: Conservative treatment of luxations and subluxations of the lower cervical spine. Ann. Chir. Gynaec. Fenn.63, 57–68 (1974)
O'Flynn, J. D.: Neurogenic bladder in spinal cord injury. Urol. Clin. N. Amer.1, 155–162 (1974)
Peerless, S. J., Schweigel, J. F.: The medical and economic fate of twenty-nine industrial spinal cord injured patients. Paraplegia12, 145–150 (1974)
Riggins, R. S., Kraus,: The risk of neurologic damage with fractures of the vertebrae. J. Trauma17, 126–133 (1977)
Roy-Camille, R., Saillant, G., Berteaux, D., Salgado, V.: Osteosynthesis of thoraco-lumbar spine fractures with metal plates screwed through the vertebral pedicles. Reconstr. Surg. Traumat.15, 2–16 (1976)
Silver, J. R.: The prophylactic use of anticoagulant therapy in the prevention of pulmonary emboli in one hundred consecutive spinal injury patients. Paraplegia12, 188–196 (1974)
Taylor, R. G.: Spinal cord injury: Its many complications. AFP8, 138–146 (1973)
Tsuji, I., Nakajima, F., Nishida, T., Abe, N.: Neurogenic bladder in spinal cord injury. Urol. Clin. N. Amer.1, 139–146 (1974)
Vincent, P. J., Smith, J., Danglasan, E.: Treatment of patients with spinal cord injuries. Canad. Nurse71, 26–30 (1975)
Vivian, J. M., Bors, E.: Experience with intermittent catheterization in the southwest regional system for treatment of spinal injury. Paraplegia12, 158–166 (1974)
Watson, N.: Anticoagulant therapy in the treatment of venous thrombosis and pulmonary embolism in acute spinal injury. Paraplegia12, 197–201 (1974)
Williams, E. W. M.: Traumatic paraplegia. In: Recent advances in the surgery of trauma. Matthews, D. N. (Ed.). London: J. & A. Churchill Ltd. 1963
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Härkönen, M., Lepistö, P., Paakkala, T. et al. Spinal cord injuries associated with vertebral fractures and dislocations. Arch. Orth. Traum. Surg. 94, 185–190 (1979). https://doi.org/10.1007/BF00618444
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00618444