Few injuries result in more profound and long-term disability than traumatic spinal cord injury. This study describes the demographic and epidemiologic characteristics of traumatic spinal cord injury among Oklahoma residents reported to the statewide, population-based surveillance system in 1988-1990; initial acute hospital and rehabilitation charges for 1989 are also included. There was a reported incidence rate of 40 per million population. Based on a reporting sensitivity of 77%, the "true" incidence of spinal cord injury was estimated to be 51 per million population. Motor vehicle crashes accounted for 48% of injuries. Males aged 15-29 years and blacks were at highest risk of injury. Among blacks, the injury rate due to violence was seven times that for whites or Native Americans. Alcohol/drug use was a contributing factor in 39% of injuries and was highest among males aged 20-29 years (58%), Native Americans (57%), and victims of motor vehicle crashes (48%) or violence (51%). The combined initial charges for persons receiving both acute and rehabilitative care ranged from $9,790 to $666,510, with a median of $53,410 per patient; for complete quadriplegia, the combined median charge was $88,585. Despite its low incidence, hospitalization and rehabilitation charges for spinal cord injury in 1989 caused an economic burden of an estimated $8.4 million. While the charges presented were only a small portion of the total costs of spinal cord injury, they further substantiate the need for prevention efforts targeting these debilitating, often permanent injuries. These efforts should target young males and blacks, and should focus on preventing injuries associated with motor vehicle crashes, violence, and alcohol/drug use.

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