Presentation, Management, and Outcomes of Traumatic Spinal Injuries following Coconut Tree Fall in Tanzania: a retrospective study of 44 cases.

Overview

abstract

BACKGROUND: In nations where tree harvesting constitutes a significant aspect of the economy, such as Tanzania, falls from trees represent a prevalent cause of traumatic injuries. This study investigates the characteristics of traumatic spinal injuries (TSI) resulting from falls from coconut trees. (CTF). METHODS: This was a retrospective study of a prospectively maintained spine trauma database at Muhimbili Orthopedic Institute (MOI). We included patients older than 14 yrs old, admitted for TSI secondary to CTF, and with a traumatism not more than two months before the admission. Our study analyzed patient data from January 2017 to December 2021. We compiled demographic and clinical information and details such as the distance from the site of trauma to the hospital, American Spinal Injury Association Impairment (ASIA) scale assessment, time to surgery, AOSpine classification, and discharge status. Descriptive analysis was done using data management software. No statistical computing was done. RESULTS: We included 44 patients, all of whom were male, with a mean age of 34.3 ± 12.1 years. At admission, 47.7% of the patients had an ASIA A injury, with the lumbar spine being the most commonly fractured level at 40.9%. In contrast, only 13.6% of the cases involved the cervical spine. Most (65.9%) of the fractures were classified as type A compression fractures (AO classification). Nearly all patients admitted (95.5%) had surgical indications, but only 52.4% received surgical treatment. The overall mortality rate was 4.5%. With respect to neurologic improvement, only 11.4% experienced an improvement in their ASIA score at discharge, the majority of whom were in the surgical group. CONCLUSIONS: The present study demonstrates that falls from coconut trees (CTF) in Tanzania constitute a substantial source of traumatic spinal injuries (TSI), frequently resulting in severe lumbar injuries. These findings underscore the need for the implementation of educational and preventive measures.