Outcome of a 12-week programme for management of the spinal cord injured with participation of patient's relations at Hilltop Orthopaedic Hospital, Enugu, Nigeria

Study design: Description of 12-week programme of treatment. Objectives: In Enugu, Nigeria, not all spinal injured (SCI) can be treated in teaching and orthopaedic hospitals. The 12-week programme was developed with the aim of getting such patients back into society as useful and independent as possible, using the patients relations to complement the deficiency in personnel. Setting: Enugu, Nigeria. Methods: Staged weekly programmes of assessment and treatment were mapped out to end at the twelfth week. Spinal injured patients of less than 2 weeks duration were entered into these programmes as they presented. Outcome was assessed at the end of the twelfth week. The study lasted for 6 years (January 1996 to December 2000). Results: Seventy-four patients were admitted into the study. Nine patients had incomplete cord injury of Frankel C while 65 had clinically complete injury of Frankel A on admission. Eight of the nine incomplete injuries improved to Frankel D and walked home within the 12-week programme. In the clinically complete group, eight died. Out of the 57 remaining, six recovered to Frankel D and walked home, while the remaining 51 who did not recover, 49 were conversant with wheelchair use within the 12-week programme. Conclusion: It is concluded that adoption of this programme would allow the spinal cord injured to get expert treatment within a reasonable time in less ideal hospital settings where man-power and skilled members of the spinal cord injury treatment team are lacking.