Clinico-epidemiological study of spinal injuries in a predominantly rural population of eastern Nepal: A 10 years' analysis
Open accessAbstract
Background A clinico-epidemiological study helps to plan future preventive measures and management strategies for spinal trauma. This is a 10 years' retrospective review of spinal-injury patients treated at a tertiary health center in the eastern of Nepal to determine clinico-epidemiological aspects of spinal-injury patients in a predominantly rural population of eastern Nepal.Materials and methods All medical record files of patients with spinal injury from 1996 to 2005 in the Medical Record Section of BPKIHS (B. P. Koirala Institute of Health Sciences) were studied. The preformed pro forma consisting age, sex, place of living, mode of injury, hospital stay level of injury, site of injury, associated injury, Frankel grading of neural deficit and treatment modality was filled from the record files of patients. These parameters were entered in Excel 8 and analyzed by EPI INFO 2002. Details of 896 patients of spinal injury were recorded in the 10-year period of review.Results 684 (76.35%) male and 212 (23.66%) female patients with mean age of 41.74 ± 16.53 years and 38.56 ± 15.86 years respectively were studied. Two hundred forty-two (27%) patients were from hilly districts of eastern Nepal. Fall from height [in 350 (39%) patients] was the commonest mode of spinal injury. Six hundred thirty-six (71%) patients presented with a neurological deficit. Seven hundred thirty-three (85%) patients were treated conservatively, compared to 163 (15%) surgically treated patients. One hundred forty-six (22%) patients were treated with operative interventions in the last five years.Conclusion The study shows that the most vulnerable group for spine injury was the group of patients of productive age with late presentation (i.e., injury hospital duration - 41.64 ± 54.24 hours) without proper prehospital management. The treatment modalities have changed (from conservative to surgical) in this part of the world. These specific observations help us in further planning for preventive measures and management in our setting.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Many high-income countries are moving away from primarily drug and surgical management of LBP because of their associated risks and costs, and general lack of efficacy, while such interventions are increasingly provided in Nepal.
“Remarkably, although many high-income countries are moving away from primarily drug and surgical management of LBP because of their associated risks and costs, and general lack of efficacy,10 such interventions are now increasingly provided in Nepal.11 12”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Epidemiology of Traumatic Spinal Cord Injury in Canada
Pickett, G. E., Campos-Benitez, M., Keller, J. L., & Duggal, N. (2006) · Spine · doi:10.1097/01.brs.0000207258.80129.03 · Cited by 425 · see citing works
PRIMARY OPERATIVE FIXATION OF LONG BONE FRACTURES IN PATIENTS WITH MULTIPLE INJURIES
Riska, E. B., BONSDORFF, H. V., Hakkinen, S., Jaroma, H., KIVILUOTO, O., & Paavilainen, T. (1977) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/00005373-197702000-00005 · Cited by 166 · see citing works
Noncontiguous Injuries of the Spine
Vaccaro, A. R., An, H. S., Lin, S. S., Sun, S. H., Balderston, R. A., & Cotler, J. M. (1992) · Journal of Spinal Disorders · doi:10.1097/00002517-199209000-00010 · Cited by 121 · see citing works
Tator, C. H., Duncan, E. G., Edmonds, V. E., Lapczak, L. I., & Andrews, D. F. (1995) · Spinal Cord · doi:10.1038/sc.1995.58 · Cited by 100 · see citing works
Falls from Height: Spine, Spine, Spine!
Velmahos, G. C., Spaniolas, K., Alam, H. B., de Moya, M., Gervasini, A. A., Petrovick, L., & Conn, A. K. T. (2006) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2006.07.002 · Cited by 28 · see citing works
Sommer, C., & Bereiter, H. H. (1994) · PubMed · Cited by 1 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [4]Bucholz RW Heckman JD Rockwood and Green's fractures in adults 2001 5th ed Philadelphia Lippincott Williams and Wilkins
Cited by
Sorted by citations
The global map for traumatic spinal cord injury epidemiology: update 2011, global incidence rate
Lee, B. B., Cripps, R. A., Fitzharris, M., & WING, P. C. (2013) · Spinal Cord · doi:10.1038/sc.2012.158 · Cited by 869 · see citing works
Traumatic spinal injury: global epidemiology and worldwide volume
Kumar, R., Lim, J., Mekary, R. A., Rattani, A., Dewan, M. C., Sharif, S. Y., Osorio-Fonseca, E., & Park, K. B. (2018) · World Neurosurgery · doi:10.1016/j.wneu.2018.02.033 · Cited by 657 · see citing works
Epidemiology of Traumatic Spinal Cord Injury in Developing Countries: A Systematic Review
Rahimi‐Movaghar, V., Sayyah, M. K., Akbari, H., Khorramirouz, R., Rasouli, M. R., Moradi‐Lakeh, M., Shokraneh, F., & Vaccaro, A. R. (2013) · Neuroepidemiology · doi:10.1159/000350710 · Cited by 292 · see citing works
Chiu, W.-T., Lin, H., Lam, C., Chu, S.-F., Chiang, Y. H., & Tsai, S. (2009) · Asia Pacific Journal of Public Health · doi:10.1177/1010539509355470 · Cited by 191 · see citing works
“In contrast, in developing countries, the reverse is true.(18,20,29,30-32) Taking Australia,(13) for example, TAs accounted for 43% of injuries and falls for 31%.”
BackgroundTraumatic spinal cord injuries – incidence, mechanisms and course
Hagen, E. M., Rekand, T., Gilhus, N. E., & Grønning, M. (2012) · Tidsskrift for Den norske legeforening · doi:10.4045/tidsskr.10.0859 · Cited by 72 · see citing works
Sharma, S., Jensen, M. P., Moseley, G. L., & Abbott, J. H. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-026874 · Cited by 61 · see citing works
A Systematic Review of Neurosurgical Care in Low-Income Countries
Weiss, H., García, R. M., Omiye, J. A., Vervoort, D., Riestenberg, R. A., Yerneni, K., Murthy, N. K., Wescott, A., Hutchinson, P. J., & Rosseau, G. L. (2019) · World Neurosurgery X · doi:10.1016/j.wnsx.2019.100068 · Cited by 53 · see citing works
“Eleven articles (7%) had the exact replication of patient population,(14-24) and 22 (14%) had some overlap of patient population.(25-46) The 154 articles were published between 1973 and 2019, with 49% of articles (n 1⁄4 76) being from the last 5 years (2014e 2018; see Figure 2).”
BackgroundSharma, S., Jensen, M. P., Moseley, G. L., & Abbott, J. H. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-022423 · Cited by 33 · see citing works
“The primary objectives of the study are related to feasibility of an RCT, specifically: (1) willingness to participate in an RCT, (2) feasibility of assessor blinding, (3) eligibility and recruitment rates, (4) acceptability of screening procedures and random allocation, (5) possible contamination between the groups,…”
BackgroundThorn, B. E. (2020) · Pain · doi:10.1097/j.pain.0000000000001839 · Cited by 30 · see citing works
“In current practice, however, clinics delivering unimodal biomedical interventions are flourishing (and such treatments are increasingly provided even in developing countries).(5,7) Meanwhile, interdisciplinary pain treatment programs, despite their superiority over unimodal treatments,(25,39,87) have steadily decline…”
BackgroundA Study of Injuries and Violence Related Articles in Nepal
Joshi, S. K., & Shrestha, S. (2009) · Journal of Nepal Medical Association · doi:10.2139/ssrn.1518938 · Cited by 22 · see citing works
Hua, R., Shi, J., Wang, X., Yang, J. F., Zheng, P., Cheng, H., Li, M., Dai, G., & An, Y. (2012) · Spinal Cord · doi:10.1038/sc.2012.133 · Cited by 19 · see citing works
Baba, A. N., Paljor, S. D., Mir, N. A., Maajid, S., Bashir, N., Bhat, A. H., & Bhat, J. A. (2010) · PubMed · Cited by 11 · see citing works
Munakomi, S., Bhattarai, B., & Cherian, I. (2017) · F1000Research · doi:10.12688/f1000research.12911.1 · Cited by 9 · see citing works
Mapping Orthopedic Research Trends in Nepal (2000-2024): A Scopus-Based Bibliometric Study
Regmi, A., & Niraula, B. B. (2025) · Indian Journal of Orthopaedics · doi:10.1007/s43465-025-01528-w · Cited by 8 · see citing works
Covell, M. M., Naik, A., Shaffer, A. L., Cramer, S. W., Alan, N., Shabani, H. K., Rabiel, H., Rosseau, G. L., & Arnold, P. M. (2023) · Neurosurgery · doi:10.1227/neu.0000000000002765 · Cited by 8 · see citing works
“26,29,30 Bajracharya et al reported a mean delay of over 40 hours to hospital presentation, which was attributed to distance to the hospital, inadequate transportation, and referral delay.”
BackgroundEpidemiology of traumatic spinal cord injury in Nepal: A systematic review
Parajuli, B., Acharya, K., & Shrestha, D. (2020) · Asian Journal of Medical Sciences · doi:10.3126/ajms.v11i6.30151 · Cited by 8 · see citing works
Neyaz, O., Kanaujia, V., Yadav, R. K., Sarkar, B., Azam, M. Q., & Kandwal, P. (2023) · Annals of Rehabilitation Medicine · doi:10.5535/arm.23107 · Cited by 5 · see citing works
Incidencia y Características del Trauma Raquimedular en un Hospital de III Nivel, Bogotá 2011–2014
Teherán, A. A., Castro, O. J., & Laverde-Frade, L. (2016) · Panamerican Journal of Trauma Critical Care & Emergency Surgery · doi:10.5005/jp-journals-10030-1157 · Cited by 4 · see citing works
Bashirian, S., Khazaei, S., Jenabi, E., Zobdeh, Z., Biglari, M., Afshari, M., & Gholamaliee, B. (2019) · Archives of Trauma Research · doi:10.4103/atr.atr_38_19 · Cited by 4 · see citing works
“Evidence indicates that musculoskeletal injuries are the most common consequences of falling, although head and spinal cord injuries are common in these individuals.[7,8] The severity of injuries related to falling depends on the height, direction of falling, landing surface, and patients’ age.”
BackgroundShrestha, S., Shrestha, K., & Groves, C. C. (2022) · Spinal Cord Series and Cases · doi:10.1038/s41394-022-00545-3 · Cited by 3 · see citing works
“6 hours to reach the trauma centre [6].”
BackgroundTraumatic Spinal Cord Injury among Patients Admitted to the Spine Unit in a Tertiary Care Centre
Gautam, S., Rijal, B., & Sharma, L. K. (2023) · Journal of Nepal Medical Association · doi:10.31729/jnma.8292 · Cited by 2 · see citing works
Kadhao, A. V., Ramesh, A., & Nagarajan, K. (2023) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_1145_22 · Cited by 2 · see citing works
Pattern of Traumatic Spinal Cord Injury in a Tertiary Rehabilitation Center of Northern India
Mishra, S. R., Srivastava, M. K., Kumar, D., Gupta, A. K., & Yadav, G. (2018) · Indian Journal of Physical Medicine and Rehabilitation · doi:10.5005/jp-journals-10066-0029 · Cited by 2 · see citing works
A STUDY OF EPIDEMIOLOGY OF SPINE INJURY IN FALL FROM HEIGHT
Antony, A., Jakob, V., & Sediguli, S. (2016) · Journal of Evidence Based Medicine and Healthcare · doi:10.18410/jebmh/2016/896 · Cited by 1 · see citing works
Constantine, S., & Wilkinson, C. (2012) · Journal of Medical Imaging and Radiation Oncology · doi:10.1111/j.1754-9485.2012.02420.x · Cited by 1 · see citing works
MRI Evaluation in Acute Spinal Trauma in Tertiary Center of Nepal
Acharya, R., Chhetri, P. K., Prasad, V. N., Thapa, K., Mishra, M. K., & Ghimire, A. (2023) · Journal of College of Medical Sciences-Nepal · doi:10.3126/jcmsn.v19i1.53465 · Cited by 1 · see citing works
Gowthaman, N. (2017) · Journal of Medical Science And clinical Research · doi:10.18535/jmscr/v5i11.142
Upreti, A., Paudel, S., Ghimire, N., Lakhey, R. B., & Kafle, D. (2026) · OTA International The Open Access Journal of Orthopaedic Trauma · doi:10.1097/oi9.0000000000000527
“7,9,15,16 Nepal ’ s 2021 census found that 66.6% of the population now lives in urban areas.”
Influential
- Authors
- Bajracharya, S., Singh, M., Singh, G., & Shrestha, B.
- Affiliations
- B.P. Koirala Institute of Health Sciences (NP)
- Corresponding author
- Bajracharya, Suraj
- Venue
- Indian Journal of Orthopaedics
- Published
- 2007
- Volume
- 41
- Issue
- 4
- Pages
- 286
- ISSN
- 0019-5413 (ISSN-L)
- PMC
- PMC2989505
- OpenAlex
- W2033063748
- Cited by
- 28
- References
- 6
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 5 · 2022: 1 · 2020: 2 · 2019: 3 · 2018: 3 · 2017: 2 · 2016: 2 · 2013: 2 · 2012: 3
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- cc-by
- Locations
- Indian Journal of Orthopaedics (publishedVersion)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Spinal Fractures and Fixation Techniques
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Keywords
- spinal injuries, rural population, Eastern Nepal, fall from height, neurological deficit, Frankel grading, conservative treatment, surgical treatment, prehospital care, spinal injury prevention
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
