Ballistic spinal Cord trauma and insecurity in Burkina Faso: cases of the injured treated in the emergency room

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Résumé

Background: The security situation facing Burkina Faso since 2015 has caused various traumas for which the neurosurgery service is called upon in many different aspects. Unfortunately, not all the regions surrounding the center of the country are spared.
Aim of the study: analyze the management in our department of patients with spinal cord injuries due to the security situation in Burkina Faso.
Methods: this was a retrospective study focusing on patients received in the neurosurgical emergencies of Tingandogo University Hospital following a terrorist attack during the month of May 2022 to June 2024.
Results: 12 injured people were collected; including 9 males, with an average age of 35.8 years. The average time to arrival at the neurosurgical emergency room was 3 days. 05 injured came from the Eastern region, 03 in the Boucle of Mouhoun. 07 patients were polytrauma, combining thoracic, visceral and orthopedic injuries. Thoracic spinal cord involvement was 58.3%, followed by lumbar involvement in 35% and cervical in 16.6%. 50% of patients were ASIA A clinically. A CT scan was performed in all patients. All patients benefited from penny wound debridement with and without projectile extraction. 07 patients were stabilized by osteosynthesis. The evolution was marked by 04 improvement in the ASIA score, 1 death. 10 patients developed decubitus complications.
Conclusion: Unfortunately, few people injured due to terrorist attacks arrive at neurosurgical emergencies and then after a long delay, making the emergency notion obsolete and worsening the prognosis of patients. It is therefore essential to set up centers offering specialized neurosurgery care in different regions of the country and to improve the evacuation chain for the injured.

Mots-clés

ballistic, spinal Cord trauma, insecurity, ASIA score.