With the rising number of accidents in the country, there has been a significant increase in the number of spinal cord injuries in the last two decades. Spinal experts caution that this number is expected to rise sharply if preventive steps are not taken on a priority basis. Although the exact incidence of spinal injuries in India is not known, some pilot studies have estimated the incidence as around 20 per million population.
Across the globe, road traffic crashes are generally the most common cause of spinal cord injuries. However, some studies suggest that fall from height may be the most common cause in many parts of India whereas in some other parts it may be road traffic crashes. Domestic falls, fall of load from height, fall while carrying heavy load, diseases (tuberculosis / tumors of spine etc.), violence, sports injuries and water accidents (diving) are the other causes of spinal “The dictum that Prevention is better than Cure is especially relevant for spinal injuries as the chances of recovery in complete spinal cord injuries are generally slim due to lack of the inherent capacity of the spinal cord to undergo neuronal regeneration. Simple measures for prevention can be effective to prevent what otherwise is perhaps the most devastating ailment which can afflict mankind. Hence Association of Spine Surgeons of India (ASSI) decided to come up with a position statement which highlights broad strategies for prevention of SCI”, says Dr. Sajan Hegde, President-ASSI, Consultant Spine Surgeon & Head, Department of Orthopaedics, Apollo Hospitals, Chennai.
“Prevention programmes can be translated into action through the 4 E’s of injury prevention and control including Education, Engineering, Enforcement and Emergency Care. Broad approaches for prevention programmes include infrastructure development, environmental modifications, legislation and community education”, says Dr. Ram Chaddha, President Elect – ASSI and Prof. & Head, Department of Orthopaedics – K.J. Somaiya Medical College, Sion, “Prevention strategies have not been given due emphasis in India and in other developing countries. This has been despite the fact that it has been amply demonstrated in that prevention strategies can be successfully implemented to reduce disability, morbidity and mortality cost effectively. This may partly be due to constraints in availability of resources to organise prevention campaigns especially when faster results can be achieved using the same resources for communicable diseases. However the policy-makers need to be sensitized that in the long run prevention programs prove to be cost effective. Further, the strategies of prevention need to be especially adapted for India since the vast majority of the population (72.2%) lives in rural areas and most of the accidents take place at home or in the unorganized sector,” says Dr. H.S. Chhabra, Secretary, ASSI & Medical Director, Indian Spinal Injuries Centre.
“An integrated approach involving all stakeholders is essential for success. Active inputs are thus required in terms of resources, support and cooperation from policy-makers, professionals, the public and the press; and most importantly political commitment,” says Dr. Saumyajit Basu, Jt Secretary-ASSI, Consultant Spine Surgeon, Park Clinic and Kothari Medical Center, Kolkata.