Trends in Demographics and Markers of Injury Severity in Traumatic Cervical Spinal Cord Injury
JournalJournal of Neurotrauma
PublisherMary Ann Liebert Inc.
MetadataShow full item record
AbstractOver 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 ≥15 years of age for years 2001-2018. Among 1420 patients, 78.3% were male with a mean age 51.5 years. Etiology included falls (46.9%), motor vehicle collisions (MVCs; 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) whereas proportion attributable to MVCs and sports injuries decreased (p < 0.001). Incomplete injuries, AMS, and the proportion of patients with no fracture dislocations increased whereas complete injuries decreased significantly. IMLL declined (p = 0.17) and proportion with hematomyelia did not change significantly. In adjusted regression models, increase in age and decreases in 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. Further, 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. Copyright Bizhan Aarabi et al. 2021; Published by Mary Ann Liebert, Inc.
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/15338
- Efficacy of Ultra-Early (< 12 h), Early (12-24 h), and Late (>24-138.5 h) Surgery with Magnetic Resonance Imaging-Confirmed Decompression in American Spinal Injury Association Impairment Scale Grades A, B, and C Cervical Spinal Cord Injury.
- Authors: Aarabi B, Akhtar-Danesh N, Chryssikos T, Shanmuganathan K, Schwartzbauer GT, Simard JM, Olexa J, Sansur CA, Crandall KM, Mushlin H, Kole MJ, Le EJ, Wessell AP, Pratt N, Cannarsa G, Lomangino C, Scarboro M, Aresco C, Oliver J, Caffes N, Carbine S, Mori K
- Issue date: 2020 Feb 1
- Cervical spine injuries in children: a review of 103 patients treated consecutively at a level 1 pediatric trauma center.
- Authors: Brown RL, Brunn MA, Garcia VF
- Issue date: 2001 Aug
- Intramedullary Lesion Length on Postoperative Magnetic Resonance Imaging is a Strong Predictor of ASIA Impairment Scale Grade Conversion Following Decompressive Surgery in Cervical Spinal Cord Injury.
- Authors: Aarabi B, Sansur CA, Ibrahimi DM, Simard JM, Hersh DS, Le E, Diaz C, Massetti J, Akhtar-Danesh N
- Issue date: 2017 Apr 1
- Epidemiology of traumatic cervical spinal fractures and risk factors for traumatic cervical spinal cord injury in China.
- Authors: Wang H, Xiang Q, Li C, Zhou Y
- Issue date: 2013 Dec
- Proposal of a Management Algorithm to Predict the Need for Expansion Duraplasty in American Spinal Injury Association Impairment Scale Grades A-C Traumatic Cervical Spinal Cord Injury Patients.
- Authors: Aarabi B, Chixiang C, Simard JM, Chryssikos T, Stokum JA, Sansur CA, Crandall KM, Olexa J, Oliver J, Meister MR, Cannarsa G, Sharma A, Lomangino C, Scarboro M, Ahmed AK, Han N, Serra R, Shea P, Aresco C, Schwartzbauer GT
- Issue date: 2022 Dec