[Injuries of the cervical spine. Review of 70 cases treated over a 5-year period at the "Fondation Jeanne Ebori" of Libreville, Gabon (Central Africa)]

Abstract

The authors report their experience of 70 cases of cervical spine injuries treated locally, over a 5 years period, 1981 to 1986, at the Fondation Jeanne Ebori Hospital by a multidisciplinary approach. An etiologic survey shows a predominance of male (82.85%) with a peak in incidence between 21 and 30 years (41.43%). Traffic accidents represented the principale cause (74.3%). 29.4% of the lesions involved the upper cervical spine (C1 + C2). 70.6% involved the lower cervical spine (C3 to C7). Clinically, 53% had neurological problems based on entrance examinations of which 49% were complete tetraplegics. Therapeutically, 20% were treated conservatively (traction, collar, etc); 68.57% underwent a surgical intervention; and in 11.43% of the cases abstention seemed the better alternative. Generally, we did not refuse treatment to any injury, even those who came late for care. We aimed chiefly at stabilizing the lesions to facilitate nursing care. Thus, after lengthy multidisciplinary discussions, in particular with the practitioners involved with intensive care and rehabilitation, we hesitated to operate on patients who were tetraplegic with respiratory problems that necessitated assisted ventilations, knowing its morbid outcome. All of our cases posed socio-economic problems. The gravity of this class of pathology is confirmed by its high rate of mortality (22.58%); that is, 16 death out of 70 patients of which 14 were tetraplegics.