Medico-legality of Acute Spinal Cord Injuries

December 4, 2024 updated by: Marwa Khalid Mohamed Ismail, Assiut University

Medico-legal Aspects of Acute Spinal Injuries At Trauma Unit of Assiut University Hospital

  1. Describe different medico-legal aspects of TSI (mode of trauma, cause and Pattern of spinal injuries).
  2. Assess the outcome of TSI in studied cases.
  3. Associate type of trauma with the different patterns of acute spinal injuries.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

A medico-legal case (MLC) applies to any case of injury or medical condition in which law enforcement agencies seek to investigate and fix the responsibility regarding the said injury or medical condition. From a physician's perspective, a MLC is a medical or clinical case with legal implications. In such cases presented directly to the hospital, after obtaining a detailed history and examination of the patient, the physician concludes the need for the law enforcement administration to investigate further. Besides, such cases could also be referred to the physician by the law enforcement administration for application of medical expertise and opinion to aid in the administration of justice .

Trauma is the 6th leading cause of death worldwide resulting in 5 million of all deaths. It is the 5th leading cause of significant disability . In Egypt, injuries the fifth leading cause of death and the most common cause of hospitalization and account for at least 1/4 of all inpatient(World Health Organization 2009). Spine is one of the body parts that is commonly subjected to trauma . Traumatic spinal injuries as seen from a medico-legal point of view, is an integral part of medical practice in emergency department..

SCI is associated with permanent disability and decreased life expectancy .Although more than 80% of the world's population live in the more than 100 developing countries, little information is available regarding the epidemiology of SCI in these countries . The higher prevalence of TSI may be due to the increased frequency of events causing injury, such as road traffic accidents (RTAs), and higher rates of occupational-related incidents, such as falls from trees .

Permanent infirmity is a major sequel of spinal fractures, it is considered as a legal as well as a medical problem. Physician should be oriented about the legal issues of compensation to help them in saving patients' rights . The cervical spinal cord is the most commonly affected level, followed by the thoracic and lumbar . Lower thoracic lesions can cause paraplegia while lesions at cervical level are associated with quadriplegia.

Concerning the mechanisms of injury, they differ in different age groups: common causes are road accidents, followed by traumas caused by falls, attacks, sports, or occupational-related Incidents . Imaging investigations showing different types of spinal cord injuries including fracture, dislocation, damage to the intervertebral discs, ligament tear, vascular affection, and associated injures . TSI occurs more frequently and has worse outcomes in low and middle-income countries than in high-income countries .

The number of disabled has increased considerably. The development constitutes a good reason for paying more specific attention to society's growing number of disabled. To our knowledge, up to 2024 there is a deficient studies in medico-legal aspect of traumatic spinal injuries and its squeals in Upper Egypt.

Study Type

Observational

Enrollment (Estimated)

120

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

A structured data sheet is prepared and included the following:

(A)Patients' demographic and epidemiological data such as age, sex, residence, education and marital state.

(B)Mode of trauma (accidental, homicidal, suicidal). (C)Cause of injury like motor car, motor cycle accident, fall from height, blunt trauma, sports, occupation….etc.

(D)Method of arrival to hospital. (E)Time passed between trauma and arrival at hospital. (F)How to deal with the TSI patients from the time of the injury until arrival at hospital.

(G)Examination findings, including careful documentation of the neurological status.

(H)Imaging findings, including plain X-rays, MSCT, and MRI. (I)Type and level of the injury (fracture, dislocation, ligament tear, associated bone injuries…etc).

(J)Sequels (deformity, disability, permanent infirmity and death). (K)Hospital stay period and operations

Description

Inclusion criteria:

  • All patients presenting with acute TSI regardless level of injury, or neurological status.

Exclusion criteria:

  • Patients have congenital anomalies, neurological defects or disability before trauma.
  • Patients with pathological spinal cord diseases were excluded.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Evaluation of medico-legal aspects of traumatic spinal injury cases includind 1 mode of trauma: suicidal, homicidal or accidental 2 causes :road traffic injuries, fall from height, assault from other...etc 3 Pattern: type and level of the injury.
Time Frame: baseline

A structured data sheet is prepared and included the following:

(A)Patients' demographic and epidemiological data such as age, sex, residence, education and marital state.

(B)Mode of trauma (accidental, homicidal, suicidal). (C)Cause of injury like motor car, motor cycle accident, fall from height, blunt trauma, sports, occupation….etc.

(G)Examination findings, including careful documentation of the neurological status.

(H)Imaging findings, including plain X-rays, MSCT, and MRI. (I)Type and level of the injury (fracture, dislocation, ligament tear, associated bone injuries…etc).

(J)Sequels (deformity, disability, permanent infirmity and death). this data will be collected from the patients and analysis to data
baseline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Determine the association between causes of trauma( motor car, motor cycle accident, fall from height, blunt trauma, sports, occupation….etc) with the different patterns of acute spinal injuries including type and level from imaging investigation.
Time Frame: baseline
after analysis of data we will make a correlation between the data like Determine the association between causes of trauma( motor car, motor cycle accident, fall from height, blunt trauma, sports, occupation….etc) with the different patterns of acute spinal injuries including type :fracture or dislocation and level :cervical or lumber from imaging investigation .
baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Investigators

  • Study Director: Doaa Mohamed Abd El Rahman, Assistant Professor, Doaa Mohamed Abd El Rahman
  • Study Director: Ali Mohamedein Mohamed, professor, Ali Mohamedein Mohamed

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

January 1, 2025

Primary Completion (Estimated)

December 31, 2025

Study Completion (Estimated)

January 31, 2026

Study Registration Dates

First Submitted

November 27, 2024

First Submitted That Met QC Criteria

November 30, 2024

First Posted (Actual)

December 5, 2024

Study Record Updates

Last Update Posted (Estimated)

December 6, 2024

Last Update Submitted That Met QC Criteria

December 4, 2024

Last Verified

November 1, 2024

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Acute spinal cord injuries

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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