Road traffic accidents account for 44% of spinal cord injuries: Study

New Delhi: The Indian Spinal Injuries Centre’s (ISIC) data on traumatic spinal cord injury admissions from 2012 to 2022 reveals astonishing facts pertaining to Spinal Cord Injuries (SCI) and reveals that despite government efforts to improve safety through measures such as compulsory seat belts, helmet-wearing, and better road infrastructure, road traffic accidents (RTA) continue to be the leading cause of spinal cord injuries in India.

The ISIC had 1,537 patients as a total number of patients and patients with SCI due to RTA accounting for 661 individuals (44%) and FFH accounting for 588 individuals (38.3%).

The latest data, in comparison to a Study conducted by ISIC nearly a decade ago, manifested that over a decade there has been no significant improvement pertaining to SCI. A peer-reviewed study conducted by ISIC and published in the journal Spinal Cord nearly a decade ago revealed significant demographic differences in spinal cord injuries between India and developed countries. The study revealed a lower mean age, a higher proportion of males, and a prevalence of injuries caused by two-wheeler accidents and falls. Road traffic accidents (45%) and falls from height (39.63%) were the primary modes of injury during the period of 2002-2010, based on 1138 admissions to the hospital.

A comparative analysis with the National Spinal Cord Injury Statistical Centre (NSCISC) data from Birmingham, UK (2010-2018), reveals that vehicular accidents accounted for 38.52% of cases, falls from height 31.13%, acts of violence 13.55%, and sports/recreational activities 8.57%.

On the global observance of Spinal Cord Injury (SCI) Day, commemorated annually on September 5th, ISIC joins hands with the International Spinal Cord Society (ISCOS) to advocate for “Access to SCI Services – A Life Less Complicated.” This year’s theme underscores the pressing need for comprehensive solutions to address catastrophic spinal cord injuries and promote a more inclusive society for SCI patients.

Dr. Vikas Tandon, Chief of Spine Services at ISIC, said, “Spinal cord injuries are life-altering, affecting not just physical health but also emotional, social, and vocational aspects. Our data highlights the persistent challenge of road traffic accidents in India, and we call for a multifaceted approach, from recognizing SCI in government policies to enhancing accessibility and rehabilitation.”

“Our aim is to contribute to an end-to-end solution for individuals grappling with spinal cord injuries and to foster a society that embraces diversity and inclusivity,” added Dr Tandon.

Rehabilitation plays a crucial role in improving the functional abilities of persons with SCI (PWSCI). It encompasses various facets, including physiotherapy, occupational therapy, peer counseling, plastic surgery, psychological mentorship, nursing care, assistive technology, urological care, and vocational support, often requiring post-surgical intervention to stabilize the spinal column.

“Rehabilitation costs are typically not covered by government schemes like CGHS, DGEHS, ECHS, and many insurance companies, posing challenges for SCI patients. However, a recent directive from the Delhi High Court, issued on August 26, 2023, directed 29 insurance companies to include coverage for disabled persons, marking a significant step toward equality and ongoing medical support for SCI patients,” said Dr Chitra Kataria – Chief of Rehabilitation, ISIC.

“Rehabilitation which is indeed the most important aspect after such injuries making these patients learn the new normal way of life is still not covered under any government schemes like CGHS, DGEHS, ECHS, etc. Most insurance companies do not cover the cost of rehabilitation and assistive devices which is essential for achieving maximum independence post-surgical intervention,” added Dr Kataria.

The experts also advocated for the recognition of persons with disabilities due to SCI. The Indian Rights of Disabilities Act 2016 currently does not classify SCI as a separate disability but rather associates it solely with locomotor disability. The experts argued that recognizing SCI as a distinct disability is essential to ensure that SCI patients receive appropriate support, including government benefits, reservations, vocational assistance, and travel concessions. The World Health Organization (WHO) recognizes SCI as one of the most devastating disabilities globally.

Achieving universal accessibility for SCI patients remains a top priority. Towards the goal of fostering inclusivity, Sugandh Ahluwalia, Chief Strategy Officer, ISIC said, “We are actively seeking to employ individuals with PwSCI and other disabilities for suitable positions.” She urged interested candidates to reach out to the ISIC’s Human Resources Department for placement opportunities.

Experts emphasized the need for inter-departmental coordination between law enforcement, civil society, healthcare institutions, and insurers to prevent road accidents and ensure comprehensive post-trauma rehabilitation.

ISIC provides all solutions under one roof with 10 highly experienced, internationally trained, and dedicated spine surgeons. “We have also established India’s first dedicated neuro-urology department to take care of SCI patients who suffer considerably after spine surgery and remain neglected. ISIC supplements its treatment and care by providing world-class Rehab,” said Dr. Dinesh Suman, Director, Department of Neuro-Urology, ISIC.

Narrating their traumatic and life-threatening conditions and a journey to normal-active life due to world-class treatment, care, and rehab at ISIC, Mr. Sourabh Tripathy- “I had met a road accident I was lucky to be landed up at ISIC and got medical intervention by the highly experienced team of spine surgeons. In ISIC during my 11 months of rehab, I learned how to live with the injury and what things I must do to improve my life. I worked as a software consultant and currently, I am enhancing my knowledge in software, nutrition, and nutrition areas.”

Echoing similar sentiments, Mr. Nilmani, said, “I met with a road accident on December 31, 2020 with complete paraplegia of d3-D-4 injury. I was rehabilitated in ISIC for the rehabilitation process, bowel bladder training, and activities for daily living. Now, I am working with Sylvac and handling online activities.  People need to be aware of not only the availability of world-class facilities and an experienced team of experts but also of the importance of post-operative rehab.”

As India faces the staggering reality of 1.2 lakh fatalities and 12 lakh serious injuries from road accidents annually, and with 1.5 million people living with spinal cord injuries, the call for a more inclusive society and robust support systems is now more critical than ever. On the occasion of SCI Day, the experts at ISIC strongly advocated for a holistic solution that includes surgical interventions and comprehensive rehabilitation programs.