Citation

Aarabi B, Albrecht JS, Simard JMMD, Chryssikos T, Schwartzbauer G, Sansur C, Crandall K, Gertner M, Howie B, Wessell A, Cannarsa G, Caffes N, Oliver J, Shanmuganathan K, Olexa J, Diaz Lomangino C, Scarboro M. J. Neurotrauma 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2020.7415

PMID

unavailable

Abstract

Over the past four decades, there have been progressive changes in the epidemiology of traumatic spinal cord injury (tSCI). We assessed trends in demographic and injury-related variables in traumatic cervical spinal cord injury (tCSCI) patients over an 18-year period at a single Level I trauma center. We included all magnetic resonance imaging confirmed tCSCI patients aged ≥ 15 years for years 2001-2018. Among 1,420 patients, 78.3% were male with mean age 51.5 years. Etiology included falls (46.9%), motor vehicle collisions (MVC) (34.2%), and sports injuries (10.9%). Median American Spinal Injury Association (ASIA) motor score (AMS) was 44, complete tCSCI was noted in 29.6% of patients, fracture-dislocations were noted in 44.7% and median intramedullary lesion length (IMLL) was 30.8 mm (complete injuries 56.3 mm and incomplete injuries 27.4 mm). Over the study period, mean age and proportion of falls increased (p<0.001) while proportion due to MVCs and sports injuries decreased (p<0.001). Incomplete injuries, AMS and the proportion of patients with no fracture dislocations increased while complete injuries decreased significantly. Mean IMLL and proportion with hematomyelia did not change significantly. IMLL declined (p=0.17) and proportion with hematomyelia did not change significantly. In adjusted regression models, the increase in age and decreases in the prevalence of MVC mechanism and complete injuries over time remained statistically significant. Changes in demographic and injury-related characteristics of tCSCI patients over time may help explain the observed improvement in outcomes. Furthermore, improved clinical outcomes and drop in IMLL may reflect improvements in initial risk assessment and pre-hospital management, advances in healthcare delivery, and preventive measures including public education.

Language: en

Keywords

EPIDEMIOLOGY; AGE; MRI; NEURAL INJURY; TRAUMATIC SPINAL CORD INJURY