Global Incidence and Characteristics of Spinal Cord Injury Since 2000-2021: a Systematic Review and Meta-analysis

Overview

Journal BMC Med

Publisher Biomed Central

Specialty General Medicine

Date 2024 Jul 7

PMID 38972971

Authors

Yubao Lu

Zhizhong Shang

Wei Zhang

Mao Pang

Xuchang Hu

Yu Dai

Ruoqi Shen

Yingjie Wu

Chenrui Liu

Ting Luo

Xin Wang

Bin Liu

Liangming Zhang

Limin Rong

Affiliations

Soon will be listed here.

Abstract

Background: This study employs systematic review and meta-analysis to explore the incidence and characteristics of spinal cord injury (SCI) between 2000 and 2021, aiming to provide the most recent and comprehensive data support for the prevention, diagnosis, treatment, and care of SCI.

Methods: Systematic searches were conducted on epidemiological studies of SCI published between January 1, 2000, and March 29, 2024. Meta-analysis, subgroup analysis, meta-regression, publication bias detection, and literature quality assessment were extensively utilized.

Results: The pooled results from 229 studies indicated that the overall incidence rate of SCI was 23.77 (95% CI, 21.50-26.15) per million people, with traumatic spinal cord injuries (TSCI) at a rate of 26.48 (95% CI, 24.15-28.93) per million people, and non-traumatic spinal cord injuries (NTSCI) at a rate of 17.93 (95% CI, 13.30-23.26) per million people. The incidence of TSCI exhibited a marked age-related increase and was significantly higher in community settings compared to hospital and database sources. Males experienced TSCI at a rate 3.2 times higher than females. Between 2000 and 2021, the incidence of TSCI remained consistently high, between 20 and 45 per million people, whereas NTSCI incidence has seen a steady rise since 2007, stabilizing at a high rate of 25-35 per million people. Additionally, the incidence of TSCI in developing countries was notably higher than that in developed countries. There were significant differences in the causes of injury, severity, injury segments, gender, and age distribution among the TSCI and NTSCI populations, but the proportion of male patients was much higher than that of female patients. Moreover, study quality, country type, and SCI type contributed to the heterogeneity in the meta-analysis.

Conclusions: The incidence rates of different types of SCI remain high, and the demographic distribution of SCI patients is changing, indicating a serious disease burden on healthcare systems and affected populations. These findings underscore the necessity of adopting targeted preventive, therapeutic, and rehabilitative measures based on the incidence and characteristics of SCI.

Citing Articles

Pre- and post-traumatic boric acid therapy prevents oxidative stress-mediated neuronal apoptosis in spinal cord injury.

Kandemir T, Sogut I, Ataizi Z, Can B, Oglakci-Ilhan A, Burukoglu-Donmez D Iran J Basic Med Sci. 2025; 28(4):444-450.

PMID: 39968086 PMC: 11831752. DOI: 10.22038/ijbms.2024.81531.17649.

Epidemiology of spinal cord injuries in three selected counties in Kenya.

Muli G, Ntsiea V, Benjamin-Damons N, Tawa N S Afr J Physiother. 2025; 81(1):2097.

PMID: 39968026 PMC: 11830909. DOI: 10.4102/sajp.v81i1.2097.

Multiparametric MRI Assessment of Morpho-Functional Muscle Changes Following a 6-Month FES-Cycling Training Program: Pilot Study in People With a Complete Spinal Cord Injury.

Mastropietro A, Peruzzo D, Taccogna M, Sanna N, Casali N, Nossa R JMIR Rehabil Assist Technol. 2025; 12():e64825.

PMID: 39819652 PMC: 11756844. DOI: 10.2196/64825.

Management of Cervical Spine Fractures and Injuries: A Literature Review.

Bharadwaj S, Balasubramanian S Cureus. 2025; 16(12):e75642.

PMID: 39803086 PMC: 11725226. DOI: 10.7759/cureus.75642.

Low-frequency bladder vibration for the treatment of urinary tract infections in spinal cord injury patients with neurogenic bladder.

Zhang Y, Cai P, Feng X, Yang Q, Wang H Int Urol Nephrol. 2024; .

PMID: 39738856 DOI: 10.1007/s11255-024-04353-6.

References

Wang X, Du J, Jiang C, Zhang Y, Tian F, Chen Z . Epidemiological characteristics of traumatic spinal cord injuries in a multicenter retrospective study in northwest China, 2017-2020. Front Surg. 2022; 9:994536. PMC: 9589158. DOI: 10.3389/fsurg.2022.994536. View

Yukawa Y, Kato F, Suda K, Yamagata M, Ueta T . Age-related changes in osseous anatomy, alignment, and range of motion of the cervical spine. Part I: Radiographic data from over 1,200 asymptomatic subjects. Eur Spine J. 2012; 21(8):1492-8. PMC: 3535253. DOI: 10.1007/s00586-012-2167-5. View

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. PMC: 8005924. DOI: 10.1136/bmj.n71. View

Miyakoshi N, Suda K, Kudo D, Sakai H, Nakagawa Y, Mikami Y . A nationwide survey on the incidence and characteristics of traumatic spinal cord injury in Japan in 2018. Spinal Cord. 2020; 59(6):626-634. DOI: 10.1038/s41393-020-00533-0. View

Sekhon L, Fehlings M . Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine (Phila Pa 1976). 2002; 26(24 Suppl):S2-12. DOI: 10.1097/00007632-200112151-00002. View

Ding W, Hu S, Wang P, Kang H, Peng R, Dong Y . Spinal Cord Injury: The Global Incidence, Prevalence, and Disability From the Global Burden of Disease Study 2019. Spine (Phila Pa 1976). 2022; 47(21):1532-1540. PMC: 9554757. DOI: 10.1097/BRS.0000000000004417. View

Roberts T, Leonard G, Cepela D . Classifications In Brief: American Spinal Injury Association (ASIA) Impairment Scale. Clin Orthop Relat Res. 2016; 475(5):1499-1504. PMC: 5384910. DOI: 10.1007/s11999-016-5133-4. View

Peters J, Sutton A, Jones D, Abrams K, Rushton L . Comparison of two methods to detect publication bias in meta-analysis. JAMA. 2006; 295(6):676-80. DOI: 10.1001/jama.295.6.676. View

Yuan S, Shi Z, Cao F, Li J, Feng S . Epidemiological Features of Spinal Cord Injury in China: A Systematic Review. Front Neurol. 2018; 9:683. PMC: 6113592. DOI: 10.3389/fneur.2018.00683. View

10.

Takao T, Morishita Y, Okada S, Maeda T, Katoh F, Ueta T . Clinical relationship between cervical spinal canal stenosis and traumatic cervical spinal cord injury without major fracture or dislocation. Eur Spine J. 2013; 22(10):2228-31. PMC: 3804697. DOI: 10.1007/s00586-013-2865-7. View

11.

Leidinger A, Zuckerman S, Feng Y, He Y, Chen X, Cheserem B . Predictors of spinal trauma care and outcomes in a resource-constrained environment: a decision tree analysis of spinal trauma surgery and outcomes in Tanzania. J Neurosurg Spine. 2023; 38(4):503-511. DOI: 10.3171/2022.11.SPINE22763. View

12.

Higgins J, Thompson S . Quantifying heterogeneity in a meta-analysis. Stat Med. 2002; 21(11):1539-58. DOI: 10.1002/sim.1186. View

13.

Ning G, Yu T, Feng S, Zhou X, Ban D, Liu Y . Epidemiology of traumatic spinal cord injury in Tianjin, China. Spinal Cord. 2010; 49(3):386-90. DOI: 10.1038/sc.2010.130. View

14.

Munn Z, Moola S, Riitano D, Lisy K . The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence. Int J Health Policy Manag. 2014; 3(3):123-8. PMC: 4154549. DOI: 10.15171/ijhpm.2014.71. View

15.

Feng H, Ning G, Feng S, Yu T, Zhou H . Epidemiological profile of 239 traumatic spinal cord injury cases over a period of 12 years in Tianjin, China. J Spinal Cord Med. 2011; 34(4):388-94. PMC: 3152810. DOI: 10.1179/2045772311Y.0000000017. View

16.

Jazayeri S, Beygi S, Shokraneh F, Hagen E, Rahimi-Movaghar V . Incidence of traumatic spinal cord injury worldwide: a systematic review. Eur Spine J. 2014; 24(5):905-18. DOI: 10.1007/s00586-014-3424-6. View

17.

Wang T, Liu K, Wang J, Xiang G, Hu X, Bai H . Spatiotemporal Regulation of Injectable Heterogeneous Silk Gel Scaffolds for Accelerating Guided Vertebral Repair. Adv Healthc Mater. 2022; 12(7):e2202210. DOI: 10.1002/adhm.202202210. View

18.

Wick J, Le H, Wick K, Peddada K, Bacon A, Han G . Patient Characteristics, Injury Types, and Costs Associated with Secondary Over-Triage of Isolated Cervical Spine Fractures. Spine (Phila Pa 1976). 2021; 47(5):414-422. DOI: 10.1097/BRS.0000000000004190. View

19.

Chan C, Eng J, Tator C, Krassioukov A . Epidemiology of sport-related spinal cord injuries: A systematic review. J Spinal Cord Med. 2016; 39(3):255-64. PMC: 5073752. DOI: 10.1080/10790268.2016.1138601. View

20.

Rahimi-Movaghar V, Sayyah M, Akbari H, Khorramirouz R, Rasouli M, Moradi-Lakeh M . Epidemiology of traumatic spinal cord injury in developing countries: a systematic review. Neuroepidemiology. 2013; 41(2):65-85. DOI: 10.1159/000350710. View