Shifting demographics, characteristics, and outcomes of traumatic spinal cord injury. A systematic review

Document Type

Review Article

Department

Medical College Pakistan

Abstract

Study design: Systematic Review OBJECTIVES: We conducted a systematic review to analyse temporal trends in the epidemiology of traumatic spinal cord injury (SCI) with a focus on patient age, SCI etiology, and baseline severity of SCI.
Methods: Five databases were searched without any restriction of date, language, or region of publication. 27 studies were included in the final analyses spanning the years 1943-2022, conducted across Europe, North America, and Asia. Data were extracted based on mean age, frequency of SCI etiology, and baseline severity.
Results: A consistent trend of increasing mean age over time across regions was observed with an annualized mean age increase of +0.46, and pooled regression based increase of +0.30 years per year across all studies. Traffic accidents as an SCI etiology have decreased, while falls have not just increased but often surpass traffic accidents. Sports related SCIs showed mixed increase and decrease across time and regions. Baseline severity decreased, shifting towards incomplete SCI, particularly incomplete tetraplegia, and higher frequency of AIS D. Complete SCI and AIS A decreased in most studies.
Conclusion: The typical individual with SCI is increasingly within the age range of 45-65 years. Etiology has shifted to low energy mechanisms like falls, and incomplete SCI is becoming common. The evolution of SCI requires further efforts for targeted prevention strategies, anticipatory health care planning, resource allocation and research, particularly in the context of an increasingly aging population. Future studies should include underrepresented regions as well as low- and middle-income countries.

AKU Student

yes

Publication (Name of Journal)

Spinal Cord

DOI

10.1038/s41393-026-01182-5

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