Spine trauma due to diving: main features and short-term neurological outcome

Spinal Cord. 2011 Feb;49(2):206-10. doi: 10.1038/sc.2010.79. Epub 2010 Jul 13.

Abstract

Study design: This is a retrospective study.

Objectives: The aim of this study is to examine the main features and short-term neurological outcomes associated with injuries to the spine due to diving into water in a Latin American country.

Setting: Salvador, Brazil.

Patient sample: A total of 1324 subjects were admitted with spinal trauma between 1991 and 2006 (inclusive). Subjects aged between 14 and 65 years who sustained diving injuries corresponded to 10.6% (N=140) of the cases.

Outcome measures: Neurological status was determined by the Frankel Functional Scale (FFS) on admission and discharge. The FFS was secondarily converted to the American Spinal Injury Association impairment scale.

Methods: This study is a patient record database review that examines demographic and injury-related characteristics, details of hospital treatment and neurological status at the time of discharge.

Results: Males (N=129) outnumbered females (N=11) in a proportion of 12:1 (mean age: 28.62 years). The cervical spine region was the most affected area (92.1%) and 45% of the cases presented with tetraplegia. On admission, neurologically complete lesions accounted for 32.1% of the overall cases and 45.7% were neurologically intact. The mean length of stay (7.7 weeks) did not differ with regard to treatment option (P=0.83). During hospitalization, patients with incomplete neurological impairment had shorter lengths of stay and showed more neurological improvement than those with complete lesions (P=0.26 and 64.5 versus 2.2%, P<0.0001).

Conclusion: Diving spine injuries have a high tetraplegia rate. Neurological recovery and shorter length of stay are associated with incomplete lesions.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Athletic Injuries / epidemiology*
  • Athletic Injuries / therapy
  • Brazil / epidemiology
  • Disability Evaluation
  • Diving / injuries*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quadriplegia / epidemiology
  • Quadriplegia / therapy
  • Radiography
  • Retrospective Studies
  • Severity of Illness Index
  • Spinal Cord Injuries / epidemiology*
  • Spinal Cord Injuries / therapy*
  • Spinal Injuries / diagnostic imaging
  • Spinal Injuries / epidemiology*
  • Spinal Injuries / therapy*
  • Young Adult