A Global Perspective on Spinal Cord Injury Epidemiology

Abstract

Spinal cord injury (SCI) is a devastating condition often affecting young and healthy individuals around the world. This debilitating condition not only creates enormous physical and emotional cost to individuals but also is a significant financial burden to society at large. This review was undertaken to understand the global impact of SCI on society. We also attempted to summarize the worldwide demographics and preventative strategies for SCI in varying economic and climatic environments and to evaluate how cultural and economic differences affect the etiology of SCI. A PUBMED database search was performed in order to identify clinical epidemiological studies of SCI within the last decade. In addition, World Bank and World Health Organization websites were used to obtain demographics, economics, and health statistics of countries of interest. A total of 20 manuscripts were selected from 17 countries. We found that SCI varies in etiology, male-to-female ratios, age distributions, and complications in different countries. Nations with similar economies tend to have similar features and incidences in all the above categories. However, diverse methods of classifying SCI were found, making comparisons difficult. Based upon these findings, it is clear that the categorization and evaluation of SCI must be standardized. The authors suggest improved methods of reporting in the areas of etiology, neurological classification, and incidence of SCI so that, in the future, more useful global comprehensive studies and comparisons can be undertaken. Unified injury prevention programs should be implemented through methods involving the Internet and international organizations, targeting the different etiologies of SCI found in different countries.

Traumatic spinal cord injury in the north-east Tanzania – describing incidence, etiology and clinical outcomes retrospectively

“…The estimated annual incidence reported in this study (more than 26 persons per million population) is relatively high as compared to the reported globally and in low income countries (23 and 25.5 persons per million population) respectively [5,12,18]. However there are other country and regional–specific studies that have reported higher annual incidences such as in Cape Town – South Africa and the United States which reports 75 and 54 persons per million population respectively [8,19].…”

“…Trauma to the spinal cord may result from a road traffic accident (RTA), fall, assault and recreational or occupational accident [1,5]. The World Health Organization informs that up to 90% of all spinal cord lesions are due to trauma and that the leading cause globally is RTA [1].…”

“…The World Health Organization informs that up to 90% of all spinal cord lesions are due to trauma and that the leading cause globally is RTA [1]. Countries and regions where RTA is the leading cause of TSCI are mostly of high income and in African cities and towns where there is dense traffic of four, three and two-wheeled motorized vehicles [1,5]. Worldwide, falls are the second leading cause of TSCI although in some parts of India, Nepal, South Asia, Estonia and Ireland it is reported the first leading cause [6].…”

“…At the same time assaults are the major cause of TSCI in South Africa [6,8]. Variation of leading causes of TSCI among countries and regions is explained by the fact that the predominating infrastructure, socioeconomic and cultural activities from which such trauma may result, are geographically not homogenous [5]. Except for the emerging motorbike use as public transport [9] rural Africa and Tanzania have fewer motorized vehicles and so causes of TSCI other than RTA can be anticipated.…”

“…Review of available reports from different countries indicates that between 170,000 and 250,000 of the world population suffer TSCI annually, with incidence rate of 23 persons per million population per year [5]. Country-specific incidence reports on TSCI are few, differ significantly and are mostly documented from high income countries [10].…”