Traumatic Spinal Cord Injury: Epidemiology
Definition
Traumatic spinal cord injury (TSCI) is damage to the spinal cord caused by external physical impact, leading to partial or complete loss of motor, sensory, and/or autonomic function below the level of injury.
Global Incidence
- Worldwide incidence: 10–80 cases per million population per year.
- Estimated annual cases: 250,000–500,000 globally (WHO).
- Data limitations: Underreporting is frequent, especially in low- and middle-income countries.
Age and Gender Distribution
- Bimodal age peak:
- Young adults (15–29 years)
- Older adults (65+), often related to falls
- Gender: Predominantly affects males (~80% of cases)
Causes
- Road traffic accidents (RTAs): 35–50%
- Falls: 20–30%, increasing in elderly populations
- Violence (gunshot, stab wounds): 10–15%
- Sports and recreation: 5–10% (e.g., diving, rugby, skiing)
Level and Severity of Injury
- Cervical injuries: Most frequent; especially C5–C7
- Thoracic injuries: Higher likelihood of complete injury
- Lumbar injuries: Often involve cauda equina syndrome
- Severity:
- Complete (ASIA A): ~30–40%
- Incomplete (ASIA B–D): ~60–70%
Mortality and Disability
- High early mortality in cervical and high thoracic injuries
- Leading cause of permanent disability in young adults
- Life expectancy:
- Reduced compared to the general population
- Improving with advances in acute and rehabilitative care
Epidemiological Trends
- Aging population: Rise in fall-related TSCI among the elderly
- Prevention efforts: Decline in RTA-related TSCI in high-income countries
- Technological advances: Better prehospital care and surgical management