Background: Despite decades of research, there are no national estimates of the incidence or prevalence of spinal cord injury (SCI) in Canada. Our objective was to utilize the best available data to estimate the incidence and prevalence of traumatic SCI (TSCI) and non-traumatic SCI (NTSCI) in Canada for 2010. Methods: Initial incidence (number of TSCIs at injury scene) and discharge incidence (number discharged into the community) were calculated using published TSCI rates from Alberta and NTSCI rates from Australia. Prevalence was estimated by applying TSCI and NTSCI discharge incidence rates to historical Canadian population demographics using a cohort survival model and age-specific mortality rates for tetraplegia and paraplegia. Results: The estimated 2010 initial incidence of TSCI is 1,785 cases per year, and the discharge incidence is 1,389 (41 per million). The estimated discharge incidence for NTSCI is 2,286 cases (68 per million). The prevalence of SCI in Canada is estimated to be 85,556 persons (51% TSCI and 49% NTSCI). Conclusions: This study provides the first estimates of the incidence and prevalence of SCI in Canada. More population-based studies are needed, particularly for NTSCI, as an increasing number of Canadians are expected to be affected by SCI.

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Study design: Forecasting using population modelling. Objectives: To determine the prevalence of non-traumatic spinal cord injury (NTSCI) on 30 June 2010. Setting: Victoria, Australia. Methods: Modelling used the following data: incidence of NTSCI based on state-wide, population-based, health-administration database of hospital admissions; state and national population profiles and life tables; levels of NTSCI based on national rehabilitation outcomes data; and life expectancy for persons with SCI. Results: The total population prevalence rate was 367.2 per million, whereas the prevalence in adults aged 16 years and older was estimated to be 2027, equivalent to a population prevalence rate of 455 per million persons. There were more males (1097) with NTSCI (prevalence rate males 197.8 per million population; females 169.1 per million population) and the prevalence was much higher among those with paraplegia (prevalence rate 269.3 per million compared to 97.8 per million with tetraplegia) and incomplete NTSCI. Ventilator dependency (prevalence rate 1.6 per million population) and paediatric NTSCI (prevalence rate 6 per million population p15 years old) were extremely rare. Conclusion: We have reported a method for calculating an estimate of the prevalence of NTSCI that provides information that will be vital to optimise health care planning for this group of highly disabled members of society. It is suggested that refinements to the modelling methods are required to enhance its reliability. Future projects should be directed at refining the mortality ratios and performing cohort survival studies. INTRODUCTIONSpinal cord injury (SCI) or damage is one of the most devastating conditions possible. It can cause a wide range of impairments, activity limitations and participation restrictions, 1,2 and has an adverse impact on the social network and wider society in which the person lives. Irrespective of the cause, persons with spinal cord damage have complex acute, rehabilitation and long-term care needs that require specialist multidisciplinary expertise in order to optimise outcomes. 3 There is, however, very little literature on the prevalence of SCI. 4 A recent review has reported a wide range in the prevalence across different regions of the world, but with a great variation in the quality of research. 5 Spinal cord damage can result from traumatic or non-traumatic causes. Although it is reported that the incidence of non-traumatic SCI (NTSCI) in some developed countries is greater than that of traumatic SCI (TSCI), 6,7 much more research has been conducted involving TSCI. As the incidence rates of NTSCI are highest in older age groups, 6 it is anticipated that both the incidence and prevalence of NTSCI will increase in many countries as a result of the projected aging of their populations.As NTSCI tends to occur in persons of older age, it is associated with more comorbidities than TSCI. 8 These comorbidities, the