Incidence of traumatic spinal cord lesions

Abstract

The incidence of acute spinal cord lesions was studied in the population of 18 Northern California counties for the years 1970 and 1971. Case ascertainment included the complete review of all hospital admissions in these counties as well as the review of all death certificates, autopsy protocols, and records of the State of California Departments of Health (Crippled Children's Service), Rehabilitation, and Industrial Relations (Workmen's Compensation). The average annual incidence rate was 53.4 per million population, and the case fatality rate was 48 per cent. Almost 56 per cent of the spinal cord injuries were attributed to motor vehicle crashes. Incidence rates were three times higher for males 20–24 yr of age and females 25–29 yr of age. The pattern of case fatality rates were not similar for males and females. Age-adjusted incidence rates were highest for black males and lowest for males of Asian origin. Risk of spinal cord injury was highest for divorced or separated persons or those who have never been married. The most frequent type of impairment among persons hospitalized with a spinal cord injury was quadriparesis. Functional impairment was related to the external cause of spinal cord injury. The use of hospitalized persons as a basis for enumeration of spinal cord injuries will result in a gross underestimation of actual incidence. Due to the extremely high costs for medical care of spinal cord injury survivors and the fact that over one-half of all persons who sustained a traumatic lesion to the spinal cord were injured as a result of a motor vehicle crash, any organized program to reduce the incidence of this tragic problem must focus on the reduction of motor vehicle crashes and/or the severity of injuries sustained in them.