Abstract / Summary
Objectives: To determine the demographic, clinical, and radiological characteristics of patients with thoracolumbar spine injuries in a tertiary care center in Nepal.
Design: Cross-sectional.
Setting: Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Participants: Eighty patients with thoracolumbar spine fractures presenting between February 2022 and August 2023.
Main outcome measures: Twenty variables adopted from the INORMUS trial protocol, including demographics, AO classification, presentation timing, and management.
Results: Men comprised 68.8% of cases; the mean age was 39.4 ± 16.4 years. Most injuries (68.8%) occurred in rural regions. Falls accounted for 71.3% of cases. Ambulance transport was used in 63.7%. Half had associated injuries. The median time to the hospital was 24 hours. The thoracolumbar junction was the most common fracture site, with L1 most frequently involved. There were 42 AO Type A, 22 Type B, and 16 Type C fractures; all Type C injuries occurred in rural settings. Neurological deficits were noted in 30%. Surgical management was performed in 49%, with a median injury-to-surgery interval of 10 days.
Conclusions: Thoracolumbar fractures predominantly affected middle-aged men from rural areas, commonly due to falls. AO Type C fractures, strongly linked to neurological deficits, were more frequent in rural patients, highlighting injury severity and geographic disparity. Patients with neurological deficits received no preferential transport, and surgical delays occurred after hospital admission. These findings underscore the need for improved trauma systems, particularly in rural Nepal, to reduce delays and mitigate injury severity.
Level of evidence: Cross-sectional, Level VI.