Epidemiology of Nontraumatic Spinal Cord Injury

Abstract

Introduction This study aims to evaluate the epidemiologic characteristics of patients with diagnosis of nontraumatic spinal cord injury (NTSCI) in a tertiary care hospital in Latin America. Patient and Methods: Retrospective single center study including 122 patients who were discharged between January 2005 and December 2012 from their initial inpatient rehabilitation after the onset of NTCSI confirmed by clinical and image studies. Descriptive statistics were performed for demographic characteristics, etiology, and the degree of neurological injury. Results From 585 patients admitted with diagnosis of spinal cord injury during the study period, 122 had NTSCI, the prevalence of NTSCI in our center was 20.9%. Of these 122 patients, 35 patients were excluded for the following different reasons: incomplete patient data in 22, 9 patients with cerebrovascular disease associated, and 4 patients with associated lesions below L2 level. Overall, 87 patients were included in the final statistical analysis, 48% male and 35.6% female. The mean age was 45.2 years, marital status of patients was 42.5% married and 29% single. Overall, 34% of patients had elementary education and 35.6% of patients were unemployed before NTSCI occurred. The lesions were classified using the American Spinal Injury Association Impairment Scale (AIS) results was AIS D (motor incomplete) in 40.22%, C (motor incomplete) in 14.94%, B (sensor incomplete) in 19.54%, and A (complete) in 24.13% of patients. The most frequent etiology was tumoral cord compression in 50 patients (57.4%) in 47 of these patients lesions were metastatic (94%) and 3 (6%) primary bone tumors. The second most frequent etiology was cervical or thoracic degenerative disease causing myelopathy in 17 patients (19.5%) followed by transverse myelitis in 9 patients (10.3%), and vertebral osteomyelitis in 7 patients (8%), arteriovenous malformations was present in 2 patients (2.29%), and undetermined in 2 patients (2.29%). Conclusion The results confirm that nontraumatic spinal cord injury represents a significant proportion of the population with spinal cord injury with a prevalence of 20.9%. Males with median age of 45 years are more frequently affected. The most common etiology is metastatic spinal lesion in 54% of patients. Most of the neurological lesions are classified as incomplete (75.87%) using the AIS scale. Epidemiological data of spinal cord injury is needed for an effective implementation of primary prevention strategies, appropriate management programs, and allocations of health resources in the field of spine surgery and rehabilitation care.