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Journal of Neurorestoratology  2018, Vol. 6 Issue (1): 1-9    doi: 10.2147/JN.S143236
Review     
Epidemiology of worldwide spinal cord injury: a literature review
Yi Kang1,2, Han Ding1,2, Hengxing Zhou1,2, Zhijian Wei1,2, Lu Liu1,2, Dayu Pan1,2, Shiqing Feng1,2
1Department of Orthopaedics, Tianjin Medical University General Hospital
2Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, People’s Republic of China
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Abstract  Study design:

A literature review of worldwide epidemiology of spinal cord injury (SCI).

Objectives:

To review the epidemiological indicators of SCI, such as incidence, prevalence, demographic characteristics, etiology, level and severity of injury, complications and mortality.

Setting:

The Department of Orthopaedics, Tianjin Medical University General Hospital, Heping District, Tianjin, People’s Republic of China.

Methods:

We searched articles published in PubMed, Medline, EMBASE and the Web of Science between January 1993 and June 2017 using the key words “spinal cord injury”, “traumatic spinal cord injury”, “non-traumatic spinal cord injury” and “epidemiology”. The incidence, etiology, prevalence, patient demographics, level and severity of injury, complications and mortality were reviewed from the articles.

Results:

The epidemiology of SCI has changed. Motor vehicle accidents and falls have become the most common reasons of injury gradually. Incidence of SCI varies by regions or countries, and it has gradually increased with the expansion of human activities. The number of male patients were significantly more than female, the average age of patients with SCI had a tendency to increase gradually. The cervical level of spine was the most common part of injury; there were more number of patients with tetraplegia than patients with paraplegia. Electrolyte disturbances, pulmonary infections, urinary tract infections and bedsores were the four most common complications.

Conclusion:

We must have a greater understanding of epidemiology to implement more preventative measures. The epidemiology in different regions is of significant difference, which may be resulted from economic, science and technology, medical, geographical and even social conditions. Therefore, we must establish appropriate intervention measures according to the particularity of population.



Key wordsspinal cord injury      etiology      incidence      patient demographics      complications     
Published: 26 June 2018
Corresponding Authors: Shiqing Feng   
About author:

*These authors contributed equally to this work

Cite this article:

Yi Kang, Han Ding, Hengxing Zhou, Zhijian Wei, Lu Liu, Dayu Pan, Shiqing Feng. Epidemiology of worldwide spinal cord injury: a literature review. Journal of Neurorestoratology, 2018, 6: 1-9.

URL:

http://jnr.tsinghuajournals.com/10.2147/JN.S143236     OR     http://jnr.tsinghuajournals.com/Y2018/V6/I1/1

StudyCountry (region)PeriodIncidencePrevalenceLeading causesSecond causesMean ageSex ratio
Montoto-Marqués et al12Galicia, Spain1995–20142.17NFallsMVCs50.23.24:1
Ta?o?lu et al14Turkey2013–20148.1–21.3NFallsMVCs38.32.31:1
Oteir et al28Victoria, Australia2007–2012NNFallsMVCs51.01.10:1
Ning et al45Chongqing, People’s Republic of China2009–2013NNFallsMVCs45.64.33:1
McCaughey et al50*Scotland1994–20130.4NOne stab woundMultiple wounds30.033.48:1
Majdan et al51Austria2002–201217.0NFallsInjuries at homeN1.86:1
Chen et al52USA2010–2014NNFallsMVCs42.23.95:1
Thompson et al34Canada2000–201116.9NMVCsFalls46.23.95:1
Sothmann et al35Cape Town, South Africa2003–2014NNMVCsViolence34.05.25::1
Selassie et al53South Carolina1998–201270.8NMVCsFalls51.52.88:1
Saunders et al54**USA1998–201226.9NMVCsViolence16.22.86:1
Sabre et al22Estonia2005–200797.0NMVCsFalls44.44.00:1
New et al24Australia1921–201121.0–32.3490.0NNN2.57–4.00:1
Mathur et al55India2000–2008NNFallsMVCsN4.20:1
L?fvenmark et al19Botswana2011–201313.0NMVCsViolenceN2.45:1
Lehre et al29Ethiopia2008–2012NNMVCsFalls31.77.59:1
Jain et al40USA1993–201254.0NFallsMVCs50.52.41:1
Chamberlain et al15Switzerland2005–201218.0NFallsSports48.02.90:1
Bellucci et al36Sao Paulo, Brazil2012NNMVCsFalls35.25.54:1
Nijendijk et al11Netherlands201014.0NFallsMVCs62.02.85:1
Katoh et al31Japan2011–2012121.4–117.1NFallsMVCs67.6–64.32.65–2.75:1
Javadi et al33***Iran1980–1988NNBulletsMVCs46.084.0:1
Shin et al38Korea2004–2008NNMVCsFalls43.62.86:1
Shrestha et al16Banepa, Nepal2008–2011NNFallsMVCsN2.77:1
Nwankwo and Uche56Southeast Nigeria2009–2012NNMVCsFalls36.14.31:1
Ibrahim et al57Kuala Lumpur2006–2009NNMVCsFalls39.03.35:1
Chen et al58USA2005–2011NNMVCsFallsN3.61:1
Wu et al59****Tianjin, People’s Republic of China2008–2011NNFallsMVCs54.64.96:1
Sabre et al17Estonia1997–200739.7NFallsMVCs39.05.45:1
Lenehan et al7British Columbia, Canada1995–200435.7NMVCsFalls35.04.00:1
Knútsdóttir et al25Iceland1975–200933.5526.0MVCsFalls38.02.57:1
Alshahri et al32Saudi Arabia2003–2008NNMVCsFalls29.57.53:1
Ning et al18Tianjin, People’s Republic of China2004–200823.7NFallsMVCs46.05.63:1
Li et al9Beijing, People’s Republic of China200260.6NFallsMVCs41.03.13:1
Hasler et al60Europe1988–2009NNMVCsFalls44.51.85:1
Yousefzadeh et al61Iran2005–2006NNMVCsFalls38.22.55:1
Qureshi et al62Rawalpindi, Pakistan2001–2008NNFallsMVCs39.13.38:1
Rahimi-Movaghar et al26Tehran, Iran2003–2008220.0440.0MVCsFalls31.01.00:1
Vitale et al30**USA1997–200019.9NMVCsFalls14.61.08:1
Pickett et al20Canada1997–2001163.4NMVCsFalls42.22.87:1
O’Connor and Murray21Ireland200013.1NMVCsFalls37.06.69:1
Dryden et al37Canada1994–1996NNMVCsFalls33.03.37:1
Dryden et al39Alberta, Canada1997–200052.5NMVCsFalls35.02.52:1
Wang et al47Taiwan, People’s Republic of China1986–1995NNMVCsViolence33.04.56:1
O’Connor63Australia1998–199914.5NMVCsFallsN3.17:1
Table 1Incidence, prevalence, etiology and patients’ demographics of SCI
StudyCountry (region)Leading levelT (%)C (%)AIS-A (%)AIS-B (%)AIS-C (%)AIS-D (%)AIS-E (%)
Montoto-Marqués et al12Galicia, SpainC4–C554.743.544.312.623.519.60
Ta?o?lu et al14TurkeyT12–L226.335.135.516.421.426.30.4
Ning et al45Chongqing, People’s Republic of ChinaC4–C654.939.339.48.721.130.80
McCaughey et al50*ScotlandCervicalN42.922.920.034.320.02.8
Majdan et al51AustriaCervicalNNNNNNN
Chen et al52USAC1–C4N46.833.713.216.236.60.4
Thompson et al34CanadaC1–C763.944.933.113.018.335.30.3
Sothmann et al35Cape Town, South AfricaCervicalN31.7NNNNN
Selassie et al53South CarolinaCervical62.310.4NNNNN
Saunders et al54**USAN41.717.4NNNNN
Sabre et al22EstoniaC1–C4NNNNNNN
Mathur et al55IndiaCervicalNN43.96.48.016.413.0
L?fvenmark et al19BotswanaC1–C459.061.0NNNNN
Lehre et al29EthiopiaLumbarN32.235.121.624.319.00
Chamberlain et al15SwitzerlandNN28.328.310.517.939.71.3
Bellucci et al36Sao Paulo, BrazilCervicalN66.966.910.98.710.92.6
Nijendijk et al11NetherlandsN69.233.5NNNNN
Katoh et al31JapanCervicalNNNNNNN
Javadi et al33***IranThoracicN91.2NNNNN
Shin et al38KoreaN60.341.242.113.221.023.70
Shrestha et al16Banepa, NepalThoracicN55.955.99.710.89.24.5
Nwankwo and Uche56Southeast NigeriaCervicalNN47.111.822.417.71.18
Ibrahim et al57Kuala LumpurN37.036.036.015.021.020.0N
Chen et al58USAC1–C4NNNNNNN
Wu et al59****Tianjin, People’s Republic of ChinaC5N5.65.616.818.958.70
Sabre et al17EstoniaCervicalN53.065.5??23.9N
Lenehan et al7British Columbia, CanadaCervical46.245.345.39.613.325.7N
Knútsdóttir et al25IcelandCervical57.039.0NNNNN
Alshahri et al32Saudi ArabiaN53.051.0NNNNN
Ning et al18Tianjin, People’s Republic of ChinaCervical71.625.225.218.214.741.90
Li et al9Beijing, People’s Republic of ChinaLumbarNNNNNNN
Hasler et al60EuropeLumbarNNNNNNN
Yousefzadeh et al61IranT10–L2N34.134.165.9??0
Qureshi et al62Rawalpindi, PakistanT11–L1N43.043.04.015.014.024.0
Rahimi-Movaghar et al26Tehran, IranLumbarN25.025.0050.025.00
Pickett et al20CanadaCervicalN35.135.111.333.128.50
O’Connor and Murray21IrelandC4–C5N39.139.117.310.932.70
Dryden et al37CanadaCervical27.919.4NNNNN
Dryden et al39Alberta, CanadaC5–C7N18.2NNNNN
Wang et al47Taiwan, People’s Republic of ChinaThoracic46.047.247.210.313.228.60.3
O’Connor63AustraliaC4–C657.037.0NNNNN
Table 2Level and severity of injury of SCI
StudyCountry (region)RI (%)ED (%)UTI (%)PU (%)PE (%)DVT (%)Depression (%)Mortality (%)
Montoto-Marqués et al12Galicia, SpainNNNNNNN11.5
Ning et al45Chongqing, People’s Republic of China7.01.91.31.9NNN1.4
McCaughey et al50*ScotlandNNNNNNN25.7
Majdan et al51AustriaNNNNNNN21.4
Thompson et al34CanadaNNNNNNN6.1
Sothmann et al35Cape Town, South AfricaNNNNNNN2.2
Selassie et al53South CarolinaNNNNNNN19.8
Saunders et al54**USANNNNNNN5.0
L?fvenmark et al19BotswanaNNNNNNN20.0
Lehre et al29Ethiopia5.6N13.5NN1.1N17.1
Jain et al40USANNN4.551.52.93N7.5
Javadi et al33***IranNNN10.65NNN5.1
Nwankwo and Uche56Southeast Nigeria7.1N11.816.5N5.9N11.8
Wu et al59****Tianjin, People’s Republic of China18.230.123.19.8N4.9N4.2
Lenehan et al7British Columbia, CanadaNNNNNNN3.1
Knútsdóttir et al25IcelandNNNNNNN6.3
Ning et al18Tianjin, People’s Republic of ChinaNNNNNNN1.4
Qureshi et al62Rawalpindi, PakistanNNNNN1.0NN
Rahimi-Movaghar et al26Tehran, IranNNN25.0NNNN
Pickett et al20CanadaNNNNNNN7.9
Dryden et al37CanadaNNNNNN28.9N
Dryden et al39Alberta, CanadaNNNNNNN22.2
Table 3Complication and mortality of SCI
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