Epidemiology Of Spinal Cord Injury Research Articles

A global map for traumatic spinal cord injury epidemiology: towards a living data repository for injury prevention

Literature review. To map traumatic spinal cord injury (TSCI) globally and provide a framework for an ongoing repository of data for prevention. An initiative of the ISCoS Prevention Committee. The results obtained from the search of Medline/Embase using search phrases: TSCI incidence, aetiology, prevalence and survival were analysed. Stratification of data into green/yellow/red quality 'zones' allowed comparison between data. Reported global prevalence of TSCI is insufficient (236-1009 per million). Incidence data was comparable only for regions in North America (39 per million), Western Europe (15 per million) and Australia (16 per million). The major cause of TSCI in these regions involves four-wheeled motor vehicles, in contrast to South-east Asia where two-wheeled (and non-standard) road transport predominates. Southern Asia and Oceania have falls from rooftops and trees as the primary cause. High-fall rates are also seen in developed regions with aged populations (Japan/Western Europe). Violence/self-harm (mainly firearm-related) was higher in North America (15%) than either Western Europe (6%) or Australia (2%). Sub-Saharan Africa has the highest reported violence-related TSCI in the world (38%). Rates are also high in north Africa/Middle East (24%) and Latin America (22%). Developed countries have significantly improved TSCI survival compared with developing countries, particularly for tetraplegia. Developing countries have the highest 1-year mortality rates and in some countries in sub-Saharan Africa the occurrence of a spinal injury is likely to be a fatal condition within a year. Missing prevalence and insufficient incidence data is a recurrent feature of this review. The piecemeal approach to epidemiological reporting of TSCI, particularly failing to include sound regional denominators has exhausted its utility. Minimum data collection standards are required.

A actividade sexual após lesão medular--meios terapêuticos.

Spinal cord injury affects man in his physical and psychic features, making him go through changes and conditioning his sexual performance. This article presents a brief review of the concept and the epidemiology of spinal cord injury, as well as erectile physiopathology. Since sexual rehabilitation considers the evaluation and the restoration of erectile dysfunction, this article reviews the therapeutic means that allow sexual life recovery, allowing a sexual life with quality, maximizing existing potentialities and promoting adaptation to limitations.

Spinal Cord Injury Management and Rehabilitation: Highlights and Shortcomings From the 2005 Earthquake in Pakistan

Rathore FA, Farooq F, Muzammil S, New PW, Ahmad N, Haig AJ. Spinal cord injury management and rehabilitation: highlights and shortcomings from the 2005 earthquake in Pakistan. Recent natural disasters have highlighted the lack of planning for rehabilitation and disability management in emergencies. A review of our experience with spinal cord injury (SCI) after the Pakistan earthquake of 2005, plus a review of other literature about SCI after natural disasters, shows that large numbers of people will incur SCIs in such disasters. The epidemiology of SCI after earthquakes has not been well studied and may vary with location, severity of the disaster, available resources, the expertise of the health care providers, and cultural issues. A lack of preparedness means that evacuation protocols, clinician training, dedicated acute management and rehabilitation facilities, specialist equipment, and supplies are not in place. The dearth of rehabilitation medicine specialists in developing regions further complicates the issue, as does the lack of national spinal cord registries. In our 3 makeshift SCI units, however, which are staffed by specialists and residents in rehabilitation medicine, there were no deaths, few complications, and a successful discharge for most patients. Technical concerns include air evacuation, early spinal fixation, aggressive management to optimize bowel and bladder care, and provision of appropriate skin care. Discharge planning requires substantial external support because SCI victims must often return to devastated communities and face changed vocational and social possibilities. Successful rehabilitation of victims of the Pakistan earthquake has important implications. The experience suggests that dedicated SCI centers are essential after a natural disaster. Furthermore, government and aid agency disaster planners are advised to consult with rehabilitation specialists experienced in SCI medicine in planning for the inevitable large number of people who will have disabilities after a natural disaster.

Epidemiology of spinal cord injuries in the 2005 Pakistan earthquake

Prospective observational study. To identify the epidemiological features specific to spinal injuries as a result of an earthquake. Rawalpindi, Pakistan in the months after the 8 October 2005 earthquake. In the month after the earthquake, the one established rehabilitation center was augmented with two makeshift spinal cord centers. Information on mechanism of injury, mode of evacuation, associated injuries was gathered, and a detailed clinical and radiological assessment was performed. Neurological status and functional outcome was determined after 10 weeks. Of an estimated 650-750 spinal cord injuries, 187 were admitted to these centers, including 80 men and 107 women with a mean age of 28.3+/-12.4 years. Injuries occurred while standing in 57.8% of patients. Most (83.4%) who reached the spinal cord center were airlifted. A urinary catheter had been placed before admission in 91.5%. Most of the patients were paraplegic 89.3, with 50.8% incomplete injuries. Fracture or fracture dislocation was present in 70, and 75% underwent spinal fixation. Although pressure ulcers (28.9%) and urinary tract infections (39%) were common, deep venous thromboses (4.8%) and depression (5.8%) were seldom detected. At 10 weeks, 75% were continent or performing intermittent catheterization. There were no deaths and two births. After a disaster, evacuation of persons with a spinal cord injury to a specialized center results in low mortality. Response planning for disasters should include early aggressive medical rehabilitation.

Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey?

Literature survey. To provide an overview of the literature data on incidence, prevalence and epidemiology of spinal cord injury (SCI) worldwide and to study their evolution since 1977. University Antwerp. The literature from 1995 onwards was searched on Pubmed. To include evolutionary data, we incorporated the results of three older studies. Two studies gave prevalence of SCI, and 17 incidence of SCI. The published data on prevalence of SCI was insufficient to consider the range of 223-755 per million inhabitants to be representative for a worldwide estimate. Reported incidence of SCI lies between 10.4 and 83 per million inhabitants per year. One-third of patients with SCI are reported to be tetraplegic and 50% of patients with SCI to have a complete lesion. The mean age of patients sustaining their injury at is reported as 33 years old, and the sex distribution (men/women) as 3.8/1. There is a need for improved registration of SCI, and publication of the findings in many parts of the world. This survey pleads for uniformity in methodology. The data show that the reported incidence and prevalence have not changed substantially over the past 30 years. Data from Northern America and Europe show higher figures for incidence, but prevalence figures have remained the same. Epidemiology of SCI seems to have changed during the last decades with a higher percentage of tetraplegia and of complete lesions. If such evolution is present worldwide, how it could eventually be prevented needs to be studied. Not applicable.

Review of spinal cord injuries in Ireland

Prospective data collection on all patients with spinal cord injury (SCI) admitted for a comprehensive management programme. To examine the epidemiology of SCI in Ireland over 1 year. Ireland's National Spinal Cord Injury Centre. Systematic data collection on all patients admitted with SCI for management. A total of 46 patients (40 males) were admitted from January to December 2000; median age was 37 years (range 6-82 years). In all, 23 of the patients presented with cervical injuries, 19 patients had thoracic injuries. In all, 18 patients had complete injuries (American spinal injuries association (ASIA)). Motor vehicle collisions were the cause of 50% of SCI. The incidence of SCI in Ireland is 13.1 per million population. Demographic data from this study can go towards improving care for patients with SCI and also in the prevention of SCI.

Spine Cord Injury: An Update

The management of spinal cord injury has advanced significantly over the past decade. The spinal cord injured patient is typically young, and represents a significant public health concern, considering improved survival rates and prolonged disabilities. This update will review recent understanding of spinal cord injury epidemiology and pathophysiology. The treating physician must have an intimate knowledge of the role of surgical and pharmacological management in order to provide optimal care, and these are reviewed herein.

Epidemiology of Cervical Spinal Cord Injury

Spinal cord injury has a devastating effect on patients, families, and society that is out of proportion to the relatively small numbers of individuals affected. The study of the epidemiology of spinal cord injury is essential to understanding this impact. This article will focus on the incidence and prevalence of spinal cord injury. Societal factors such as ethnic group, age of injury, marital status, occupational status, and discharge placement will be addressed. In addition, etiology of spinal cord injury, neurological level of injury, associated injuries, life expectancy, and lifetime costs will be addressed.

Incidence and patterns of spinal cord injury in Australia

The objective of this paper is to report on the epidemiology of spinal cord injury (SCI) based on the Australian SCI register and to discuss the implications for prevention. All adult cases of SCI are reported to the registry. The case reports for 1998/1999 were aggregated and described. The age adjusted rate of persisting SCI was 14.5 per million of population. Rates were highest in young adults and in males. The vast majority of cases (93%) were due to unintentional injury. Forty-three percent were due to motor vehicle crashes, principally from motor vehicle rollover. Cases of SCI from falls, aquatic activities, and working for income are also described. Incomplete cervical cord injuries were most common (38%), particularly as a result of motor vehicle crashes and low falls. The study indicates that the surveillance of SCI needs to be improved internationally so that comparative studies can be undertaken. It is recommended that the Centers for Disease Control case definition be adopted. Australia is one of the few countries that have a register based on that case definition, and the only one that has a register covering a full national adult population. The results presented on the basis of this data source provide some hitherto unavailable information on the incidence rates and patterns of SCI. National population based surveillance is fundamental to an understanding of the epidemiology, and hence the prevention, of this severe and costly health and welfare problem.

Epidemiology of Spinal Cord Injury and Traumatic Brain Injury: The Scope of the Problem

Traumatic injury to the central nervous system (CNS) is one of the most important issues concerning the health care system in the 1990s and will likely remain so into the next millenium. In the United States, there are 10,000 hospital admissions each year secondary to spinal cord injury (SCI), while there are more than 250,000 hospital admissions each year secondary to traumatic brain injury (TBI). The majority of SCIs occur in the young, and 55% of traumatic SCIs are sustained by people between 16 and 30 years old. A similar trend is noted in TBI with the highest incidence rate reported for those who are between 15 and 24 years old. Motor vehicle accidents (MVAs) and falls are the two most common causes of traumatic injuries to the CNS. Recent advances have lessened the incidence of MVAs related to the CNS, while there has been an increased rate of injury secondary to violence in both SCI and TBI. The issue of dual diagnosis of SCI and TBI is an important one. It is far more common for the patients with an SCI to also have a TBI diagnosed, with a rate between 24% and 50% reported. The converse of SCI diagnosed after a primary TBI is much less common with single digit rates between 1.2% and 6% reported.

Emergency department approach to acute thoracolumbar spine injury

This review provides a literature-based approach to the management of acute thoracolumbar spine (TLS) injury. The epidemiology of spinal cord injury and pertinent spinal cord anatomy are reviewed. A review of current TLS fracture/dislocation classification schemes is provided. The principal focus of this review is the immediate diagnostic and therapeutic interventions needed to maximize the recovery of patients with acute TLS injury.

Surveillance of traumatic spinal cord injury in Australia: the identification of information needs.

Monitoring the occurrence of disease through any surveillance program necessarily requires the expenditure of scarce resources. The type of information accessible through surveillance and how it may be obtained deserve careful consideration in order to justify these costs. Therefore before establishing a new system of surveillance it is advisable to ascertain the information needs of potential users and to determine the feasibility of developing a system to meet them. As part of the planning for a national traumatic spinal cord injury surveillance system in Australia these data were sought by conducting a survey of key informants in 1993. The planning and evaluation of health care services, a knowledge of spinal cord injury epidemiology and its sequelae, injury prevention, external demands for information, and facilitation of research, were identified as the most important needs for information. It has been shown that the prevalence of spinal cord injury in Australia is increasing. As this occurs the need for specialised health services will also rise. Therefore, to facilitate the rational planning of services, and to monitor the well-being of the Australian spinal cord injured population, accurate surveillance data are essential.

Epidemiology of spinal cord injuries: a reflection of changes in South African society.

The records of all patients (492 males and 124 females) admitted into a spinal rehabilitation programme over a period of 6 years were reviewed. Most of the patients were in the age group 20-29 years and trauma accounted for 89% of all spinal cord lesions. Gunshot injuries were the commonest (36%), followed by injuries related to motor vehicle accidents (MVA) (25%), stab wounds (20%) and falls from heights (2.4%). Aetiological patterns changed over the 6 year period covered: gunshot injuries increased markedly and stab wounds decreased in number. The records of a medico-legal laboratory in the same geographic region revealed the same trend. Neurological recovery rates were better in patients with stab wounds and nontraumatic lesions than in those with MVA-related injuries and gunshot wounds. When compared to similar studies from other countries, our results show a disproportionately high incidence of violent injuries, particularly gunshot wounds, in South African plegic patients. We concluded that the recent sociopolitical changes and especially the general escalation of violence in the country, is reflected in the observed changes in the epidemiology of spinal cord injuries.

Epidemiology of Spinal Cord Injury in New Zealand

Spinal cord injury (SCI) is a catastrophic and costly result of both intentional and unintentional injury. We present data from the Health Statistics Services files of New Zealand for the year 1988 on the epidemiology of SCI resulting in morbidity. New Zealand has one of the highest rates of SCI in the western world and since 1979 this has been increasing. It occurs most often to young, caucasian men and is typically the result of motor transport crashes. The ethnicity adjusted rates show high rates for Maori males. Children in New Zealand have greater than 4 times the risk of an SCI than American children. The rehabilitation and hospital costs for SCI are among the highest for all injuries. There were a higher number of high cervical injuries than reported in previous series and 92% of SCI were incomplete indicating the high rehabilitation potential of the sample. Some measures are suggested to reduce the incidence of SCI.

Epidemiology of spinal cord injury in the Rhône-Alpes region, France, 1970-75

Three hundred and fifty-one cases of traumatic spinal cord injuries concerning only inhabitants of the Rhône-Alpes region have been collected at Henry Gabrielle Hospital. Incidence and prevalence are discussed, as well as male/female ratio, causes of accidents, and their relationship to sex, race, age, vertebral level, associated injuries and profession.

Epidemiology of spinal cord injury

Accidents are the cause of some 50 deaths per 100 000 population each year in the US; some 3% of these are from traumatic spinal cord injury alone. Traumatic spinal cord injury in socioeconomically advanced countries, has a probably annual incidence rate of 3 per 100 000 population. Males are affected five times as often as females, and in the US, Negroes have twice the rates of whites. Half the cases are due to motor vehicle accidents, 1/4 to falls, and 1/10 to sports injuries. Maximal ages at risk are 15 to 34; only for cord damage due to falls do this risk differ, and here elderly are the more prone. Associated injuries are common in traumatic cord injury, and head injury and pulmonary dysfunction are frequent causes of the acute deaths in traumatic SCI which is why complete quadriplegia has a high early case-fatality ratio. Late deaths in SCI are principally the direct or indirect result of the neurogenic bladder. With treatment in comprehensive spinal cord injury centers, more than 4 of 5 traumatic SCI patients will survive ten years with an average of almost 18 years. Median survival may be almost 14 years for complete quadriplegia, 17 for complete paraplegia, 19 for incomplete quadriplegia, 20 for incomplete paraplegia and 28 for cauda equina lesions. Prevalence is likely to be some 50 per 100 000 population with about 20 per 100 000 completely paralyzed (3 quadriplegic and 19 paraplegic). Some 4 out of 5 survivors of traumatic SCI should be able to live at home and perform gainful work after such treatment. Language: en