Epidemiology of cervical spinal cord injury in eastern India: an autopsy-based study

Aims Cervical spinal cord injury is a major cause of fatality among trauma victims. Unlike developed countries, national spinal cord injury database is not maintained in India. Paucity of data hampers the understanding of epidemiology of the event in India. So, this study was conducted to ascertain the epidemiological pattern of death due to cervical spinal cord injury and to identify the risk factors; also to find the association of vertebral injuries with various epidemiological parameters. Methods Among autopsies conducted in Burdwan Medical College and Hospital from 2000 to 2010, cases with autopsy report mentioning "death due to cervical spinal cord injury" either primary or secondary were included in the study. It was a retrospective observational study based on autopsy report. Results 536 cases met the inclusion criteria. Among them 89.4% were male and 10.6% were female; 63.8% victims were young adults (20-39 years). Mean (+/- S.D.) age was 33.5 years (+/- 12.8). All, apart from 5.4%, suffered from single segment injury with commonest site being C3-C4 (37.3%). Highest number of trauma occurred between 6 am to 9 am, 56.6% of the victims died before hospitalisation. Commonest mode of injury was road traffic accident (52.2%) followed by fall from height (25.0%); 53.7% cases had vertebral fracture with dislocation, 34.3% had only vertebral fracture. Only dislocation was significantly high up to 19 years age (p<0.001) and among females (p=0.029). All elderly suffered from fracture. Conclusions This study revealed an unusually high male: female ratio with much representation of the younger age groups in the injuries in comparison to other parts of world. In absence of national database, this result can be used as a surrogate data.