Epidemiology of traumatic spinal cord injury in Asia: A systematic review

Abstract

Study design: A systematic review. Background: The number of traumatic spinal cord injury (TSCI) reports grows annually, especially in China and Korea. The epidemiological characteristics of TSCI in Asia differ from those in other countries. Thus, we compiled epidemiological factors from Asia to compare with those from other countries. Method: We searched articles published in any language between January 1980 to December 2011 using the terms "spinal cord injury", "traumatic spinal cord injury", "epidemiology", and "Asia". The articles were reviewed for information regarding TSCI incidence, total cases, case criteria, case source, causes of injury, male/female ratio, mean age, prospective or retrospective, neurological level of injury, extent of injury, and America Spinal Injury Association Impairment Scale (AIS)/grade. Results: Epidemiological data were extracted from 39 reports in the published literature that met the inclusion criteria. Only two studies reported prevalence rates. Incidence rates ranged from 12.06 to 61.6 per million. The average age ranged from 26.8 to 56.6 years old. Men were at higher risk than women. Motor vehicle collisions (MVCs) and falls were the main causes of TSCI. However, several countries reported war wounds as the major cause. The neurological level and extent of injury were mixed, and most patients were categorized as AIS/Frankel grade A. Conclusion: TSCI is an important public health problem and a major cause of paralysis. We must understand the epidemiology to implement appropriate preventative measures. Asian epidemiology is different from that in other regions, so intervention measures must be established according to population-specific characteristics.

Epidemiology of Spinal Cord Injury in Bangladesh: A Five Year Observation from a Rehabilitation Center

“…Majority of the participants of this study had traumatic paraplegia (51.9%) and the principle cause was fall from height (45.4%) and road traffic accident (25.9%) which was found to be consistent with other global literatures [3][4][5]8,9]. 40 patients reported Bull attack to be the cause of spinal cord injury in this research which is a fairly new and interesting phenomenon which was not previously reported.…”

“…Male predominance previously reported in both local [2,3,5,14] and global [1,3,4,8,9,10] studies were also found in this research where 86.8% (n=1897) were male and 13.1% (n=287) were female. Distribution of age in this study showed more people in their 2 nd decade and 3 rd decade was vulnerable to spinal cord injury which was different from Hossain et al where the mean age was 47.44 [17] and Ulrich et al who found the mean age to be 36.1 [18].…”

“…The incidence of spinal cord injury is increasing with time with an annual rate of 15-40 cases per million [2,5,7] with male predominance and a propensity of affecting the low-socio economic group [2]. The condition leads not only to varying degrees of physical disabilities including paralysis, sensory deficit, dysfunction of bowel and bladder [3,4,8,9] but also to various crippling complications such as pressure sore, autonomic dysreflexia, deep vein thrombosis, spasticity, sexual dysfunction and pneumonia [2,4,8]. On top of that, spinal cord injury poses grave impact over the economy both personal and national, as the condition itself as well as the complications lead to significant increase of cost [2,10].…”

“…Fall from height, road traffic accident, gunshot injury, sports injury is so far identified to the leading cause of injury around the world [2,4,5,10] and spinal tumor, tuberculosis(TB), transverse myelitis(TM) seems to the principle nontraumatic cause [2,5,6,9]. American Spinal Injury Association (ASIA) impairment score has been used for measuring the extent of injury and level of impairment varies from paraplegia to tetraplegia [10][11][12].…”

“…American Spinal Injury Association (ASIA) impairment score has been used for measuring the extent of injury and level of impairment varies from paraplegia to tetraplegia [10][11][12]. Regardless of the cause and extent spinal cord injury is considered to be a condition where the chance of curative treatment is very few [3,5,9] and the consequences which follow the primary event whether physical or psychological, very often lead to permanent disability as well as rate of mortality. Epidemiology of spinal cord injury varies from that of developed to developing country and so different and extensive studies are necessary in different country [3].…”