Cervical Spine Injuries in Fayed Resort: Shallow Water Accidents

Background Data: Shallow-water diving injuries have devastating consequences for patients and their families in terms of requiring intensive use of resources in both the acute and rehabilitative phases of injury. With the final clinical outcome often poor, the question is raised as to whether a target group can be identified for whom to implement a preventive program. Purpose: Our aim is to evaluate the demographics, clinical features and outcomes of shallow-water diving injuries in Fayed resort. Study Design: A descriptive analytic cross section prospective study involving 20 patients with diving accidents. Patients and Methods: During the period from January 2011 to May 2014, 20 patients who presented with diving accidents from Fayed city were surgically treated in Suez Canal University Hospital in the Neurosurgery Department. Initial treatment was made according to Advanced Trauma Life Support guidelines, followed by neurological and radiological examination to determine the severity of the injury. Neurological classification was made according to the American Spinal Injury Association/International Medical Society of Paraplegia Impairment scale. Cervical traction was used in cases of subluxation. Surgery was performed in cases of spinal instability or cord compression. Results: Neurologically, eight patients had complete ASIA, grade A, spinal cord injury, eight had incomplete spinal cord injury ASIA grade B (1 patient), grade C (3 patients), grade D (4 patients). The other 4 were normal ASIA, grade E. Five patients presented with teardrop fractures, five burst fractures, eight patients presented with flexion distraction injury including five with bilateral locked facets and three unilateral locked facets and two presented with fracture of the posterior elements. Surgical fusion was done in sixteen patients including anterior approach in fourteen patients and combined anterior and posterior approach in two patients. No neurological deterioration was recorded. Overall, 30% (6/20) patients improved neurologically during hospitalization with regard to the ASIA Impairment Scale. Conclusion: A very specific patient profile was identified, and the severity of shallowwater diving injuries was confirmed. These data should be used to motivate further educational and preventive programs for reducing the incidence of diving-related injuries. (2014ESJ087