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OBJECTIVE: Review the profile of patients with spinal trauma after diving accidents referred to the Puerto Rico Medical Center. This study intended to develop more awareness of the risks of spinal cord injury after diving. METHODS: The patient's records for diving accident cases referred to our center during January 2014 until December 2020 were assessed retrospectively. The cases were evaluated according to sex, age, vertebral level, and neurological deficit. The Puerto Rico Medical Center is the only level 1 trauma center in Puerto Rico; therefore, this study likely included all the cases of diving injury on the island. RESULTS: Sixty five patients with a median age of 29 years were identified consisting primarily of males (94%). The regions affected included the cervical (96%), thoracic (2%), and lumbar (2%) spine. Twenty-seven patients (42%) developed a spinal cord injury secondary to a diving accident. Involvement of the C4, C5, or C6 vertebral level, was significant for the development of a spinal cord injury. Diving accidents occurring at beaches were the most common cause. CONCLUSION: In Puerto Rico, there is a yearly incidence of 9.3 diving accidents causing spinal trauma; these accidents most frequently affect the C6 vertebra. These diving accidents mainly occur in young individuals, predominantly at beaches. Most of our patients were neurologically intact after their diving accident, although 42% sustained a spinal cord injury. This study provided a better understanding of this traumatic event and determined its most affected levels, accident sites, and population involved.

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OBJECTIVE: The purpose of this study is to report epidemiological and clinical data of the patients that were admitted with spinal gunshot injuries. METHODS: This was retrospective study and observational study. Patients who had a spinal injury secondary to a gunshot wound that was admitted to our hospital (level III trauma center) from July 2018 through July 2020 were included in the study. Demographic and clinical data including age, gender, civil status, occupation, level of injury (cervical, thoracic, or lumbar), degree of neurological impairment at admission, associated injuries, treatment established, length of hospital stay, and mortality rate were recorded. RESULTS: A total of 55 patients were included in the study, of which 50 patients (90.9%) were men and five female patients (9.09%). The average age was 30.2 years. Three patients died during hospitalization representing a mortality rate of 5.45%. CONCLUSIONS: Spinal gunshot injuries are associated with significant sequelae, requiring long and costly treatments. This study obtained one of the highest incidences of gunshot injuries to the spine reported in the literature.

OBJETIVO: El propósito de este estudio es reportar datos epidemiológicos y clínicos de los pacientes que ingresaron con heridas por arma de fuego en columna. MÉTODOS: Estudio retrospectivo y observacional. Se incluyeron pacientes que presentaban una lesión medular a secundaria a una herida por arma de fuego que ingresaron en nuestro hospital (centro de trauma de nivel III) desde julio de 2018 hasta julio de 2020. Se registraron datos demográficos y clínicos que incluían edad, sexo, estado civil, ocupación, grado de lesión (cervical, torácica o lumbar), grado de deterioro neurológico al ingreso, lesiones asociadas, tratamiento establecido, duración de la estancia hospitalaria y tasa de mortalidad. RESULTADOS: Se incluyeron en el estudio un total de 55 pacientes, de los cuales 50 pacientes (90,9%) eran hombres y 5 mujeres (9,09%). La edad media fue de 30,2 años. Tres pacientes fallecieron durante la hospitalización lo que representa una tasa de mortalidad del 5,45%. CONCLUSIONES: Las lesiones por arma de fuego en la columna están asociadas con secuelas importantes, que requieren tratamientos largos y costosos. Este estudio obtuvo una de las incidencias más altas de heridas por arma de fuego en la columna vertebral reportadas en la literatura.

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Spinal cord injury (SCI) is a disease that affects the normal function of the spinal cord. Road traffic accidents (RTAs) represent the main cause of SCI worldwide. SCI may generate physical disability and economic dependency, which is especially significant in low- and middle-income countries such as most of the Latin American countries. The main objective of this study was to present an epidemiological review of SCI secondary to RTAs. Stronger evidence on this condition in Latin America is important for future-specific data collection and prevention strategies. A literature review was carried out using specific search strategies in databases of indexed journals from the period 2000 to 2019. Data on SCI secondary to RTAs in the Latin American region were collected and analyzed. After initial screening and removal of duplicates, 16 articles met the inclusion criteria and were chosen for analysis. Data from 7 Latin American countries were retrievable. On average, RTAs were responsible for 40.81% of SCI. Data from different studies are heterogeneous. Car accidents and moto accidents were equally responsible for SCIs (50.61% vs. 49.06%). The thoracic segments were the most commonly affected (57.87%). Males in their 30s were the most affected category (76.6%). SCI due to RTAs may represent a severe but preventable condition that affects mostly men in their productive age, generating important social and economic issues. Data about this condition in Latin America are scarce, and could limit prevention and treatment strategies. Prospective data collection about this condition is recommended.

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Objective To analyze the epidemiological profile of patients with spinal cord injury treated at POLEM ­ Associação de Apoio às Pessoas comLesão Medular (Association for Supporting People with Spinal Cord Injury). Method The population studied comprised 113 patients with spinal cord injury, of traumatic or nontraumatic etiology, and the data obtained were compared with those of other institutions. Results Of the 113 patients, 70.8% were male and 29.2% female. Traumatic lesions were responsible for 54% of the patients, and nontraumatic for 46%. Of the patients with traumatic injury, 90.2% were male, the main cause being traffic accidents. In nontraumatic lesions, women were the most affected, 51.9%; and dysraphism and myelitis were the main causes (31% and 21%, respectively). Conclusion The results showed an important incidence of spinal cord injury due to trauma,mainly affecting young individuals of productive age and low educational level, representing high economic and social costs. The data found in the present study are similar to those of other studies performed in our country.

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STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To determine the incidence and characteristics of newly injured individuals admitted to a traumatic spinal cord injury (TSCI) referral center during a 4-year period. SETTING: University Hospital of Valle, Cali, Colombia. METHODS: Individuals were identified, and their data was recorded based on the International Spinal Cord Injury Core Data Set. The outcome of interest was the American Spinal Injury Association Impairment Scale (AIS) grade at the last follow-up. RESULTS: There were 491 individuals admitted in the 4-year period. The mean annual incidence of TSCI was 56.27 per million inhabitants. Considering TSCI in individuals exclusively from Cali, the mean annual incidence was 27.78 per million. The leading cause of TSCI was interpersonal violence (47.25%) and falls (33.60%). There was a strong correlation between AIS grade at admission and last follow-up. The most common AIS grade at the last follow-up was E (34.01%) caused mostly by falls (57.48%), followed by A (31.16%) caused mostly by interpersonal violence (76.27%). The reported employment rate dropped from 75.56% to 18.94% before and after TSCI (p < 0.05). AIS grade A was associated with more post-injury complications (p < 0.05). CONCLUSIONS: This is the first cohort study in Colombia describing the incidence and AIS grades of individuals with TSCI from a trauma referral center. Interpersonal violence was overrepresented in this population. Future research should include the evaluation of prevention strategies, as well as research on interventions towards quality improvement in patient care and post-discharge services especially for individuals with AIS grade A.

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Resumen: La lesión medular traumática puede afectar todas las funciones de la médula espinal determinando limitaciones de la actividad y restricciones en la participación. Conocer el perfil epidemiológico propio es imperativo para planificar la asistencia, los recursos y actuar en prevención. En la Cátedra de Rehabilitación hay una larga trayectoria de asistencia en equipo interdisciplinario a personas con lesión medular traumática; a partir de 1987 se documentaron datos que fueron analizados y presentados en 2004 en el Congreso Nacional de Neurología. Objetivo: describir las características sociodemográficas, clínicas, funcionales y terapéuticas de nuestra población. Método: se realizó un estudio longitudinal, retrospectivo, descriptivo y analítico de toda la población asistida durante el período 2004-2017. Resultados: n=70, 86% masculino, de 40±18 años. Las causas fueron: precipitación 36,4%, tránsito 31,8% y violencia 28,8%; el nivel cervical 57%, dorsal 40% y lumbar 3%. La escala de la American Spinal Injury Association (ASIA) de inicio fue 36,2% A, 13,8% B, 22,4% C y 5,2% D. ASIA final, 29,0% A, 3,2% B, 27,4% C, 25,8% D. El 45% logró independencia en actividades básicas de la vida diaria, el 60% independencia en transferencias y el 45% en marcha. Conclusiones: disminuyó el número de nuevos casos en los últimos cuatro años y cambió el perfil etiológico. Predominaron los hombres jóvenes, lesiones por precipitación, tránsito y violencia, las cuadriparesias incompletas, seguido de paraplejias completas e incompletas. Las complicaciones más frecuentes fueron nefrourológicas y escaras. De la funcionalidad alcanzada, la mayoría de los pacientes fueron dependientes en actividades de vida diaria, transfirieron en forma independiente y no lograron marcha.

Summary: Traumatic spinal cord injury may affect all functionalities of the spinal cord, what determines limitation in activity and restrictions in participation. Learning about its epidemiological profile is of the essence to plan healthcare, resources and preventive actions. The Rehabilitation Chair has a long history in providing healthcare to people with traumatic spinal cord injury in multidisciplinary teams. Data has been recorded since 1987, which information was analysed and presented at the National Neurology Conference in 2004. Objective: to describe the socio-demographic, clinical, functional and therapeutic characteristics of our population. Method: we conducted a longitudinal, retrospective, descriptive and analytical study of the entire population assisted between 2004 and 2017. Results: n=70, 86% male, 40±18 years old. The following causes were found: falls 36.4%, road accidents 31.8% and violence 28.8%; cervical level 57%, dorsal spine 40% and lumbar spine 3%. Initial ASIA impairment scale was 36.2% A, 13.8% B, 22.4% C and 5.2% D. Final ASIA impairment scale was 29.0% A, 3.2% B, 27.4% C, 25.8% D. 45% achieved independence in everyday basic activities, 60% transfer independence and 45% independent gait. Conclusions: the number of new cases decreased in the last 4 years and the etiological profile changed. Young men prevailed, lesions caused by falls, road accidents and violence were the most frequent, incomplete quadriparesis, followed by complete and incomplete paraplegia. The most frequent complications were nephro-urological and pressure sores. As to the functionality achieved, most patients were dependent in every day life activities, they could transfer independently and could not achieve independent gait.

Resumo A lesão medular traumática pode afetar todas as funções da medula espinhal, determinando limitações de atividade e restrições de participação. Conhecer o perfil epidemiológico da população atendida é imprescindível para planejar cuidados, recursos e atuar na prevenção. A Cátedra de Reabilitação (CRMF) tem uma longa trajetória de assistência com equipe interdisciplinar às pessoas com Lesão Medular Traumática; a partir de 1987, foram registrados dados que foram analisados e apresentados em 2004 no Congresso Nacional de Neurologia. Objetivo: descrever as características sociodemográficas, clínicas, funcionais e terapêuticas da população atendida pela equipe de reabilitação da CRMF no período 2004-2007. Métodos: foi realizado um estudo longitudinal, retrospectivo, descritivo e analítico de toda a população assistida no período de 2004-2017. Resultados: 70 pacientes foram atendidos sendo 86% de sexo masculino, com idade 40 ± 18 anos. As causas foram: precipitação 36,4%, trânsito 31,8% e violência 28,8%; o nível cervical 57%, dorsal 40% e lombar 3%. A Escala da American Spinal Injury Association (ASIA) inicial era 36,2% A, 13,8% B, 22,4% C e 5,2% D. ASIA final, 29,0% A, 3,2% B, 27,4% C, 25,8% D. 45% alcançaram independência nas atividades básicas de vida diárias, 60% independência nas transferências e 45% na marcha. Conclusões: o número de casos novos diminuiu nos últimos 4 anos e o perfil etiológico mudou. Predominou o sexo masculino, as lesões por precipitação, trânsito e violência, as quadriparesias incompletas, seguidas de paraplegias completas e incompletas. As complicações mais frequentes foram nefrourológicas e escaras. Em relação à funcionalidade alcançada, a maioria dos pacientes era dependente nas atividades da vida diária, movia-se de forma independente e não conseguiram autonomia na marcha.

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Regenerative medicine offers hope for patients with diseases of the central and peripheral nervous system. Urodele amphibians such as axolotl display an exceptional regenerative capacity and are considered as essential preclinical model organisms in neurology and regenerative medicine research. Earlier studies have suggested that the limb regeneration ability of this salamander notably decreases with induction of metamorphosis by thyroid hormones. Metamorphic axolotl requires further validation as a negative control in preclinical regenerative medicine research, not to mention the study of molecular substrates of its regenerative abilities. In this study, we report new observations on the effect of experimentally induced metamorphosis on spinal cord regeneration in axolotl. Surprisingly, we found that metamorphic animals were successful to functionally restore the spinal cord after an experimentally induced injury. To discern the molecular signatures of spinal cord regeneration, we performed transcriptomics analyses at 1- and 7-days postinjury (dpi) for both spinal cord injury (SCI)-induced (experimental) and laminectomy (sham) groups. We observed 119 and 989 differentially expressed genes at 1- and 7-dpi, respectively, while the corresponding mouse orthologous genes were enriched in junction-, immune system-, and extracellular matrix-related pathways. Taken together, our findings challenge the prior notions of limited regenerative ability of metamorphic axolotl which exhibited successful spinal cord regeneration in our experience. Moreover, we report on molecular signatures that can potentially explain the mechanistic substrates of the regenerative capacity of the metamorphic axolotl. To the best of our knowledge, this is the first report on molecular responses to SCI and functional restoration in metamorphic axolotls. These new findings advance our understanding of spinal cord regeneration, and may thus help optimize the future use of axolotl as a preclinical model in regenerative medicine and integrative biology fields.

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Stingray injuries are rare, mostly causing injuries to the lower extremities but occasionally fatal if there is direct puncture of the thorax, abdomen, or neck. Direct combined stingray injury to the central nervous system has not been reported in the literature. Herein we present the case of a 12-year-old boy who, while wading at the seashore of the Costa Rica's Pacific Ocean, sustained a combined oblique penetrating injury to the C6 vertebra caused by a Stingray. He initially presented to the hospital with a complete asymmetric right C6/left T1 ASIA A examination, priapism, and loss of anal sphincter tone. Imaging revealed fracture of the posterior elements of C6 with an oblique trajectory into the left radicular foramen. T2W images did not reveal anatomical section but rather edema and minor bleeding in the epidural space. The patient underwent medical management and serial imaging. During the next 3 months, there was recovery of sensation on the right hemi body, bilateral paresthesias and asymmetric progressive improvement in strength on both legs. Acute care management and midterm term follow up are provided, along with a review of the literature for salient management considerations when evaluating and treating combined penetrating and envenomation injuries caused by stingrays. To our knowledge, this is the first report of such injury to the spine.

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Total vertebrectomy with spine shortening has been reported for the treatment of difficult cases of traumatic spine dislocation, both in acute and chronic phase. We report an exceptional case of a five-week-old T12-L1 spine dislocation in a 25-year-old female with complete paraplegia as a result of trauma in Ciudad de León (Nicaragua). In view of the time since the dislocation, we performed a complete L1 vertebrectomy in order to reduce the dorsolumbar hinge. For osteosynthesis material we had only eight screws and two Steffee plates. We therefore introduced pedicle screws at levels T11, T12, L2 and L3 on the right side and T11, T12, L3 and L4 on the left, and performed manual reduction of the spine. Steffee plates were placed and we added sublaminar wires to reinforce the osteosynthesis. Fifteen months after surgery, there has been no neurological improvement.

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OBJECTIVE: To standardize a spinal cord lesion mouse model. METHODS: Thirty BALB/c mice were divided into five groups: four experimental groups and one control group (sham). The experimental groups were subjected to spinal cord lesion by a weight drop from different heights after laminectomy whereas the sham group only underwent laminectomy. Mice were observed for six weeks, and functional behavior scales were applied. The mice were then euthanized, and histological investigations were performed to confirm and score spinal cord lesion. The findings were evaluated to prove whether the method of administering spinal cord lesion was effective and different among the groups. Additionally, we correlated the results of the functional scales with the results from the histology evaluations to identify which scale is more reliable. RESULTS: One mouse presented autophagia, and six mice died during the experiment. Because four of the mice that died were in Group 5, Group 5 was excluded from the study. All the functional scales assessed proved to be significantly different from each other, and mice presented functional evolution during the experiment. Spinal cord lesion was confirmed by histology, and the results showed a high correlation between the Basso, Beattie, Bresnahan Locomotor Rating Scale and the Basso Mouse Scale. The mouse function scale showed a moderate to high correlation with the histological findings, and the horizontal ladder test had a high correlation with neurologic degeneration but no correlation with the other histological parameters evaluated. CONCLUSION: This spinal cord lesion mouse model proved to be effective and reliable with exception of lesions caused by a 10-g drop from 50 mm, which resulted in unacceptable mortality. The Basso, Beattie, Bresnahan Locomotor Rating Scale and Basso Mouse Scale are the most reliable functional assessments, and but the horizontal ladder test is not recommended.

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OBJECTIVE: To standardize a spinal cord lesion mouse model. METHODS: Thirty BALB/c mice were divided into five groups: four experimental groups and one control group (sham). The experimental groups were subjected to spinal cord lesion by a weight drop from different heights after laminectomy whereas the sham group only underwent laminectomy. Mice were observed for six weeks, and functional behavior scales were applied. The mice were then euthanized, and histological investigations were performed to confirm and score spinal cord lesion. The findings were evaluated to prove whether the method of administering spinal cord lesion was effective and different among the groups. Additionally, we correlated the results of the functional scales with the results from the histology evaluations to identify which scale is more reliable. RESULTS: One mouse presented autophagia, and six mice died during the experiment. Because four of the mice that died were in Group 5, Group 5 was excluded from the study. All the functional scales assessed proved to be significantly different from each other, and mice presented functional evolution during the experiment. Spinal cord lesion was confirmed by histology, and the results showed a high correlation between the Basso, Beattie, Bresnahan Locomotor Rating Scale and the Basso Mouse Scale. The mouse function scale showed a moderate to high correlation with the histological findings, and the horizontal ladder test had a high correlation with neurologic degeneration but no correlation with the other histological parameters evaluated. CONCLUSION: This spinal cord lesion mouse model proved to be effective and reliable with exception of lesions caused by a 10-g drop from 50 mm, which resulted in unacceptable mortality. The Basso, Beattie, Bresnahan Locomotor Rating Scale and Basso Mouse Scale are the most reliable functional assessments, and but the horizontal ladder test is not recommended.

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Artisanal fishermen around the world employ scuba and surface-supplied diving for their livelihoods and often undergo provocative dive profiles due to economic pressures. Consequently, rates of decompression sickness (DCS) are much greater than in recreational scuba divers. Here we present the case of a surface-supplied diving fisherman from the Yucatán Peninsula of Mexico, who suffered a significant episode of spinal DCS and underwent hyperbaric oxygen therapy treatments, with a favorable outcome. Additionally, we review the proposed mechanisms underlying spinal DCS.

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BACKGROUND: Spinal cord injury (SCI) has a negative impact on quality of life and healthcare costs. In recent years with the age pyramid inversion, there has been a high prevalence of SCI in the elderly. These patients must be studied in order to invest in the prevention and treatment of SCI in these patients. OBJECTIVE: To identify the characteristics and clinical aspects of spinal cord injury (SCI) in the elderly. METHODS: Retrospective study of elderly patients (≥ 60 years of age) with a clinical diagnosis of SCI. Clinical and socio-demographic variables were collected from medical records. RESULTS: Sixty-two elderly patients were studied (56% men). The patients were analyzed according to gender. Women presented compression fractures associated with thoracolumbar transition, while men presented with listhesis associated with cervical lesions and increased complications. It was found that the need for surgical intervention was higher in men. Among many characteristics that differed between the elderly and younger people (< 60 years; n = 259), in the morphological diagnosis, we observed that compression fractures and dislocation fractures were more highly associated with ages ≥ 60 and < 60, respectively. After SCI, the elderly have a higher risk for late hemodynamic instability. CONCLUSION: Elderly individuals with SCI have distinct characteristics and clinical factors related to gender and age.

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OBJECTIVE:: analyze social representations in the life trajectory of artisanal fishermen with spinal cord injury caused by diving on the north coast of Rio Grande do Norte. METHOD:: a descriptive, qualitative study was conducted with 31 fishermen between October 2013 and August 2014, using a semi-structured interview. A lexicographic analysis and descending hierarchical classification of texts were performed (with software ALCESTE), in the perspective of the social representations. RESULTS:: social representations of fishermen with spinal cord injury presented experiences with physical limitations and expectations regarding retirement, which appeared as a distant reality from the requirements in Brazilian labor laws. CONCLUSION:: measures are required for the promotion, prevention and rehabilitation of the health of fishermen with spinal cord injury, as well as safe and decent fishing conditions, with the commitment of health authorities.

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RESUMO Objetivo: analisar as representações sociais da trajetória de vida dos pescadores artesanais com lesão medular vítimas de acidente por mergulho nas praias do litoral Norte do Rio Grande do Norte. Método: estudo descritivo, de natureza qualitativa, desenvolvido com 31 pescadores entre outubro de 2013 e agosto de 2014, mediante entrevista semiestruturada. Empregou-se a análise lexicográfica e classificação hierárquica descendente dos textos (software ALCESTE), sob a ótica das Representações Sociais. Resultados: as representações sociais dos pescadores com lesão medular apresentaram as experiências com as limitações físicas e expectativas de aposentadoria, estas últimas configurando-se como uma realidade distante das exigências impostas por nossas leis trabalhistas. Conclusão: exigem-se medidas de promoção, prevenção e reabilitação da saúde do pescador vítima de lesão medular, além de condições seguras e dignas de trabalho como compromisso das políticas de saúde.

RESUMEN Objetivos: analizar las representaciones sociales de la historia de vida de pescadores artesanales con lesión medular víctimas de accidente de buceo en las playas del litoral Norte de Rio Grande do Norte. Método: estudio descriptivo, de naturaleza cuantitativa, desarrollado con 31 pescadores entre octubre de 2013 y agosto de 2014, mediante entrevista semiestructurada. Se empleó análisis lexicográfico y clasificación jerárquica descendiente en los textos (software ALCESTE), en la visión de las Representaciones Sociales. Resultados: las representaciones sociales de los pescadores con lesión medular expresaron las experiencias de las limitaciones físicas y expectativas de jubilación, configurándose éstas como realidad distante de las exigencias impuestas por la legislación laboral vigente. Conclusión: se requieren medidas de promoción, prevención y rehabilitación de la salud del pescador víctima de lesión medular, además de condiciones laborales seguras y dignas, con compromiso de las políticas de salud.

ABSTRACT Objective: analyze social representations in the life trajectory of artisanal fishermen with spinal cord injury caused by diving on the north coast of Rio Grande do Norte. Method: a descriptive, qualitative study was conducted with 31 fishermen between October 2013 and August 2014, using a semi-structured interview. A lexicographic analysis and descending hierarchical classification of texts were performed (with software ALCESTE), in the perspective of the social representations. Results: social representations of fishermen with spinal cord injury presented experiences with physical limitations and expectations regarding retirement, which appeared as a distant reality from the requirements in Brazilian labor laws. Conclusion: measures are required for the promotion, prevention and rehabilitation of the health of fishermen with spinal cord injury, as well as safe and decent fishing conditions, with the commitment of health authorities.

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PURPOSE: This is a pilot study to compare changes in the amplitude, area below the curve, number of phases, duration, and latency of the intraoperative transcranial motor evoked potentials (TcMEP) for early detection of impending spinal cord injury. An empirical ratio calculated by a combination of the above-mentioned parameters was also assessed. METHODS: Intraoperative TcMEP recordings from five patients presenting with neuromuscular kyphoscoliosis, idiopathic scoliosis, achondroplasia and lumbar kyphosis, congenital kyphosis, and achondroplasia with cervical instability were reviewed. Anesthesia was sustained with propofol or sevoflurane plus remifentanil, no muscle relaxants were used after intubation. The TcMEPs to multipulse electrical stimulation were recorded from upper-limb and lower-limb muscles. To be worthy of analyses, changes should include TcMEP disappearance or amplitude decrease >-65% during surgical/force maneuverings. RESULTS: Transient TcMEP changes related to surgical/force maneuvering were observed in all five patients consisting of a decrease in the empirical ratio value (>-95%), followed in magnitude by a drop in the area below the curve, amplitude (>-80%), duration, and number of phases, whereas latency increased. Changes returned to baseline when maneuverings were reverted. No hemodynamic/anesthetic factors were present during these events. After surgeries, no new neurological deficits were detected. CONCLUSIONS: An empirical ratio accounting for all TcMEP parameters seems to drop more than the amplitude during an intraoperative event. As few cases were analyzed, further studies in larger series of patients will be necessary to assess empirical ratio sensitivity/specificity and to determine whether this may be a useful monitoring warning criterion not leading to unnecessary interference with surgical treatment.

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STUDY DESIGN: Retrospective study. OBJECTIVES: To evaluate the demographic and clinical characteristics of patients diagnosed with spinal cord injury (SCI) admitted to a single center. SETTING: Single center study, México. METHODS: This study reviewed 433 patients with SCI. Data were extracted from medical records and retrospectively reviewed. RESULTS: A total of 433 patients with a diagnosis of SCI were included in the analysis. Of these, 346 (79.9%) had traumatic SCI (TSCI) and 87 (20.1%) had non-traumatic SCI (NTSCI). The principal causes of traumatic TSCI were motor vehicle accidents in 150 patients (43.4%), falls in 107 patients (30.9%) and a result of firearms in 58 patients (16.8%). Tumoral cord compression was the main cause of NTSCI in 50 patients (57.4%), followed by degenerative disease-causing myelopathy in 17 patients (19.5%). The proportion of patients affected with NTSCI was significantly lower, 29.9 vs 79.1% (P=0.0001), the age of patients was higher 53.9 vs 37.8 (P<0.002) and SCI was less severe, AIS D 41.33 vs 9.5% (P=0.0001) compared with the TSCI group. CONCLUSIONS: The demographic profiles of patients with TSCI and NTSCI differ in terms of proportion of total SCIs, patient age, male:female ratio and incomplete vs complete injury. The most common etiology of TSCI was motor vehicle accidents (43.4%), and neurological lesions were complete in 62.7% of patients. The most common etiology of NTSCI was tumoral spinal lesions (57.4%), and lesions were incomplete in 75.8% of patients.

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STUDY DESIGN: Review of clinical data. OBJECTIVES: The objective of this study was to describe the clinical and demographical profile of patients with traumatic spinal cord injury (TSCI) admitted to a single center. SETTING: Unidad de Medicina Física y Rehabilitación Centro, México. PARTICIPANTS: Patients with TSCI attending rehabilitation for the first time. INTERVENTION: Not applicable. MAIN MEASUREMENTS: Age, gender, educational level, occupational activity, causes of injury, level of injury, neurological level, injury severity and category were recorded. RESULTS: Four hundred and sixty-four clinical files of patients with TSCI were collected. The mean age was 37.9 ± 15.9 years; 78.2% (363/464) were male, basic educational level predominated in 63.6% (296/464) and 73.1% (339/464) were employed. A fall was the main mechanism of the injury in 41.6% (193/464), replacing automobile accidents from the first place. The mean age of persons who suffered falls was 44 ± 16 years. Injuries sustained by younger persons were due to violence (28.4 ± 10.1 years) and the cause of injury associated with male gender was violence. Thoracic level was most often affected (in 56.7%, 263/464) and neurological level C4 in 13.4% (62/464). In regard to the extent of the injury, lesions classified as American Spinal Injury Association A predominated (56.2%, 261/464) as with complete paraplegia in 43.3% (201/464). CONCLUSIONS: The mean age of our patients was 37 years. Men are affected in a higher proportion. Our population has <9 years of study. Physical labor was the usual pre-injury activity. The main mechanism of injury was falls. Thoracic spine was the most affected.

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