Epidemiology of spinal cord injury

Abstract

Worldwide, the average prevalence of spinal cord injury (SCI) is estimated to be 1:1000, and the mean incidence is proposed to be between 4 and 9 cases per 100,000 population per year. Numbers vary substantially for different parts of the world. The mean incidence of SCI in developing countries is estimated to be 25.5/million/year with a range between 2.1 and 130.7/million/year. The incidence of SCI in industrialized countries ranges from 15 in Western Europe to 39/ million/year in the USA. Most common causes for traumatic SCI are traffic accidents, falls, and results of violence, whereas the leading causes of non-traumatic SCI (NTSCI) are degenerative diseases and tumors (developed countries) and infections, particularly tuberculosis and HIV (developing countries). The majority of people with traumatic SCI are males (ratio men/women = 3:1), whereas in non-traumatic SCI, genders are almost equally distributed. Worldwide NTSCI increases significantly as well as the number of high-level tetraplegic patients with the need for permanent or artificial ventilation. In general, the percentage of tetraplegic patients has increased and nowadays equals that of paraplegic patients. Additionally, in industrialized countries, the mean age at the time of injury increases continuously, mostly due to older patients also experiencing SCI. The mortality rate in the first phase after SCI is directly linked to the availability and quality of primary care and rehabilitation approaches. Life expectancy is determined by the level of integration into a proper socioeconomic environment after initial treatment and directly related to the availability of qualified medical care in the event of complications such as pressure ulcers or urological problems.