Cobb angle changes in thoracic and lumbar spine fractures following road traffic injuries in Gwagwalada, Abuja

Abstract

Background: This is a retrospective study to evaluate the short-term clinical outcome of conservative treatment of all consecutive patients that were treated for closed thoracic and lumbar spine fractures following Road Traffic Injury (RTI) at the University of Abuja Teaching Hospital (UATH) Gwagwalada, Abuja Nigeria

Method: Age, gender, mechanism of injury, time of presentation, symptoms, type of fracture, serial Cobb angle of the plain radiograph between 1st Jan 2008 and 31th December 2008 were studied from case notes.

Result: A total of sixteen patients with closed thoracic and lumbar spine fractures were seen during the review period. The male: female ratio was 3:1 with a median age of 36 years. The peak incidence was in the month of July (18.8%). Ten (62.5%) patients presented within a week of the injury. The predominant symptom was back pain (100%). Commercial bus (56.3%) was the most common mode of transportation causing RTI with spinal fractures. The first lumbar vertebra (L1) (25.0%) was the most frequently fractured spine and the most common fracture pattern was compression fracture (56.3%). At the index evaluation, the mean Cobb angle was 28.3º± 7.2º with an average progression of 9.8º± 4.2º at twenty-four weeks of conservative treatment.

Conclusion: This is not an uncommon injury. The patients were predominantly male adult, sustaining injury mostly in commercial bus accidents. The thoracolumbar spine was the most common fracture site and the commonest fracture pattern was compression fracture. The short term clinical outcome of conservative treatment was not satisfactory.