Summary and ConclusionsThe work was conducted on 102 patients who sustained traumatic thoracic and lumbar spine injuries during the period from July 1999 to March 2004 at neurosurgery division of Al-Zagazig University Hospital.The cases were divided into two main groups:1. Conservative group:Thirty patients who admitted lately, had major, severe and multiple associated systemic injuries or had a major medical contraindication for spinal surgery.2. Surgical group:Seventy-two patients were admitted early after injury, had spinal surgical intervention within 30 days of the injury.Evaluation of the extent of neurological function was done by using the numerical Yale Scale Scoring system.All patients had plain X-rays, CT scans and MRI images for initial evaluation and in the follow up period.We have achieved the following results: The age range was 13-60 years with a mean of 38 years. There were 68 men (66.6%) and 34 women (33.4%) with male to female ratio was 2:1. Traffic accidents were the causative trauma in 53 patients (52%) and fall from height were the cause in 49 patients (48%). Early presentation after injury in the first 24 hours was found in 62 patients (86.1%) in surgical group while late presentation more than 5 weeks after injury was found in 12 patients (40%) of conservative group. Clinical data:a. Back pain:Was noted in all cases, radicular pain in 32 patients (31.4%). The pain was severe in 97 patients (95.1%).b. Initial neurological status:1. Surgical group: 72 patientsNo neurological deficits (score 10) 13 patients (18%)Incomplete neurological deficits (scores 9-1) 52 patients (72.2%).Complete neurological deficits (score 0) 7 patients (9.7%)2. Conservative group: 30 patientsNo neurological deficits 8 patients (26.7%)Incomplete neurological deficits 17 patients (56.6%).Complete neurological deficits 5 patients (16.7%)c. Bladder function1. Surgical group:Normal bladder 29 patients (40.3%)Bladder dysfunction 43 patients (59.7%).2. Conservative group:Normal bladder 12 patients (40%)Bladder dysfunction 18 patients (60%).d. Associated systemic injuries:* Other associated injuries were found in 32 patients (31.4%).* Head injuries in 22 patients (21.6%).* Single associated injury was noted in 23 patients (22.5%) and multiple injuries in 9 patients (8.8%).* Patients in conservative group had more frequent, severe, and multiple associated injuries than in surgical group. Radiological data:a. Level of spinal injury:* Thoracolumbar was the most common involved region in 77 patients (75.5%).* L1 vertebra was the most common vertebra involved by the injury in 41 patients (40.2%).b. Number of vertebrae involved by the injury:* Single vertebral injury was found in 83 patients (81.4%).* Multiple vertebral injuries in 19 patients (18.6%) which was contiguous in 15 patients (14.7%) and non-contiguous in 4 patients (3.9%).c. Types of spinal injuries:* Wedge compression fractures were found in 16 patients (16.7%).* Burst fractures were found in 78 patients (70.5%) where superior end plate fracture type was the commonest, found in 50 patients (64.1%).* Fracture dislocations, found in 8 patients (7.8%).d. Involvement of the posterior vertebral elements by the injury was found in 19 patients (18.6%).e. Reduced vertebral height:* The range was 16-72%.* The mean was 58.6%.* More than 50% loss of vertebral height was noted in 43 patients with burst fractures (55.2%).f. Canal compromise:* The range was 17-76%.* The mean was 48.6%.* More than 50% canal compromise was noted in 49 patients (62.8%).g. Spinal kyphosis:1. Surgical group:* The range was 13-39 degrees.* The mean was 25.3 degree.* More than 25 degrees angulation was found in 31 patients (43.1%).2. Conservative group:* The range was 8-24 degrees.* The mean was 16.7 degree. Management:a. Conservative group:* Complete bed rest until pain was tolerable.* Use of analgesics to control pain.* Use external orthoses.* Program of physiotherapy.b. Surgical group:* Timing of surgery: the range of interval between injury and operation was 5-27 days. The mean was 11.7 days.* Type of surgery:a. Decompressive procedures: In 59 patients who had incomplete or comlete neurological deficits:1. Laminectomy in 20 patients (33.8%).2. Transpedicular in 23 patients (38.9%).Summary and conclusion: There are many obstacles faced in getting care from reproductive health programs such as; SRH policy and access to services which are heavily influenced, often negatively, by socio cultural and political factors; women’s relative lack of decision-making power; Poverty, cultural traditions and legal barriers restrict their access to financial resources; Lack of knowledge and information about SRH issues and also, structural factors associated with health system such as the way in which the service is provided, the quality of the service provision, inequality in health resources allocation especially within the rural regions and the extent to which the different sectors within the health system are linked with regard to resource sharing and service delivery.Key words: Sexual and reproductive health (SRH), STIs/ AIDS, Maternal and child health, unsafe Abortion, Family planning, Obstacles, FGM, Adolescent and sexual health.