Ann Rehabil Med.  2024 Feb;48(1):86-93. 10.5535/arm.23107.

Epidemiology of Traumatic Spinal Cord Injury in the Himalayan Range and Sub-Himalayan region: A Retrospective Hospital Data-Based Study

Affiliations
  • 1Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Rishikesh, India
  • 2Department of Physical Medicine and Rehabilitation, Uttar Pradesh University of Medical Sciences, Saifai, India
  • 3Department of Trauma Surgery, All India Institute of Medical Sciences, Rishikesh, India
  • 4Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India

Abstract


Objective
To compile epidemiological characteristics of traumatic spinal cord injury (TSCI) in the Northern Indian Himalayan regions and Sub-Himalayan planes.
Methods
The present study is a retrospective, cross-sectional descriptive analysis based on hospital data conducted at the Department of Physical Medicine and Rehabilitation and Spine Unit of Trauma Centre in a tertiary care hospital in Uttarakhand, India. People hospitalized at the tertiary care center between August 2018 and November 2021 are included in the study sample. A prestructured proforma was employed for the evaluation, including demographic and epidemiological characteristics.
Results
TSCI was found in 167 out of 3,120 trauma patients. The mean age of people with TSCI was 33.5±13.3, with a male-to-female ratio of 2.4:1. Eighty-three participants (49.7%) were from the plains, while the hilly region accounts for 50.3%. People from the plains had a 2.9:1 rural-to-urban ratio, whereas the hilly region had a 6:1 ratio. The overall most prevalent cause was Falls (59.3%), followed by road traffic accidents (RTAs) (35.9%). RTAs (57.2%) were the most common cause of TSCI in the plains’ urban regions, while Falls (58.1%) were more common in rural plains. In both urban (66.6%) and rural (65.3%) parts of the hilly region, falls were the most common cause.
Conclusion
TSCI is more common in young males, especially in rural hilly areas. Falls rather than RTAs are the major cause.

Keyword

Spinal cord injuries; Trauma; Demography; Epidemiology

Figure


Reference

1. Pickelsimer E, Shiroma EJ, Wilson DA. Statewide investigation of medically attended adverse health conditions of persons with spinal cord injury. J Spinal Cord Med. 2010; 33:221–31.
2. McCammon JR, Ethans K. Spinal cord injury in Manitoba: a provincial epidemiological study. J Spinal Cord Med. 2011; 34:6–10.
3. Kumar R, Lim J, Mekary RA, Rattani A, Dewan MC, Sharif SY, et al. Traumatic spinal injury: global epidemiology and worldwide volume. World Neurosurg. 2018; 113:e345–63.
4. Jain NB, Ayers GD, Peterson EN, Harris MB, Morse L, O’Connor KC, et al. Traumatic spinal cord injury in the United States, 1993-2012. JAMA. 2015; 313:2236–43.
5. Mitchell J, Nunnerley J, Frampton C, Croot T, Patel A, Schouten R. Epidemiology of traumatic spinal cord injury in New Zealand (2007-2016). N Z Med J. 2020; 133:47–57.
6. Bjørnshave Noe B, Mikkelsen EM, Hansen RM, Thygesen M, Hagen EM. Incidence of traumatic spinal cord injury in Denmark, 1990-2012: a hospital-based study. Spinal Cord. 2015; 53:436–40.
7. Kristinsdottir EA, Knutsdottir S, Sigvaldason K, Jonsson H Jr, Ingvarsson PE. [Epidemiology of spinal cord injury in Iceland from 1975 to 2014]. Laeknabladid. 2016; 102:491–6. Icelandic.
8. Jiang B, Sun D, Sun H, Ru X, Liu H, Ge S, et al. Prevalence, incidence, and external causes of traumatic spinal cord injury in China: a nationally representative cross-sectional survey. Front Neurol. 2022; 12:784647.
9. Derakhshanrad N, Yekaninejad MS, Vosoughi F, Sadeghi Fazel F, Saberi H. Epidemiological study of traumatic spinal cord injuries: experience from a specialized spine center in Iran. Spinal Cord. 2016; 54:901–7.
10. Shrestha P, Shrestha S, Shrestha RK. Retrospective study of spinal cord injury patients admitted to spinal injury rehabilitation center, Sanga, Banepa, Nepal. Nepal Med Coll J. 2014; 16:169–72.
11. Mathur N, Jain S, Kumar N, Srivastava A, Purohit N, Patni A. Spinal cord injury: scenario in an Indian state. Spinal Cord. 2015; 53:349–52.
12. Kirshblum S, Waring W 3rd. Updates for the International Standards for Neurological Classification of Spinal Cord Injury. Phys Med Rehabil Clin N Am. 2014; 25:505–17, vii.
13. Alizadeh A, Dyck SM, Karimi-Abdolrezaee S. Traumatic spinal cord injury: an overview of pathophysiology, models and acute injury mechanisms. Front Neurol. 2019; 10:282.
14. Chhabra HS, Arora M. Demographic profile of traumatic spinal cord injuries admitted at Indian Spinal Injuries Centre with special emphasis on mode of injury: a retrospective study. Spinal Cord. 2012; 50:745–54.
15. Farooq Khan Q, Bilal H, Khan M, Ahmad N, Jaffar M, Ayaz M, et al. The prevalence of traumatic spinal cord injury in Khyber Pakhtunkhwa from 2008 to 2017: a cross sectional study. Int J Sci Eng Res. 2018; 9:776–82.
16. Bakhsh A, Aljuzair AH, Eldawoody H. An epidemiological overview of spinal trauma in the Kingdom of Saudi Arabia. Spine Surg Relat Res. 2020; 4:300–4.
17. National Spinal Cord Injury Statistical Center. Traumatic spinal cord injury facts and figures at a glance [Internet]. National Spinal Cord Injury Statistical Center;2022 [cited 2023 Oct 7]. Available from: https://msktc.org/sites/default/files/SCI-Facts-Figs-2022-Eng-508.pdf.
18. Barbiellini Amidei C, Salmaso L, Bellio S, Saia M. Epidemiology of traumatic spinal cord injury: a large population-based study. Spinal Cord. 2022; 60:812–9.
19. Montoto-Marqués A, Ferreiro-Velasco ME, Salvador-de la Barrera S, Balboa-Barreiro V, Rodriguez-Sotillo A, Meijide-Failde R. Epidemiology of traumatic spinal cord injury in Galicia, Spain: trends over a 20-year period. Spinal Cord. 2017; 55:588–94.
20. Majdan M, Brazinova A, Mauritz W. Epidemiology of traumatic spinal cord injuries in Austria 2002-2012. Eur Spine J. 2016; 25:62–73.
21. Wyndaele M, Wyndaele JJ. Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey? Spinal Cord. 2006; 44:523–9.
22. Agarwal P, Upadhyay P, Raja K. A demographic profile of traumatic and non-traumatic spinal injury cases: a hospital-based study from India. Spinal Cord. 2007; 45:597–602.
23. Wang H, Xiang L, Liu J, Zhou Y, Ou L. Gender differences in the clinical characteristics of traumatic spinal fractures among the elderly. Arch Gerontol Geriatr. 2014; 59:657–64.
24. Go BK, DeVivo MJ, Richards JS. The epidemiology of spinal cord injury. In : Stover SL, DeLisa JA, Whiteneck GG, editors. Spinal cord injury: clinical outcomes from the model systems. Gaithersburg, MD: Aspen Publisher;1995. p. 21–55.
25. The World Factbook. South Asia [Internet]. The World Factbook;1995 [cited 2023 Sep 6]. Available from: https://www.cia.gov/the-world-factbook/countries/india/#people-and-society.
26. Office of the Registrar General and Census Commissioner. Ministry of Home Affairs: Census 2011- provisional population total [Internet]. Office of the Registrar General and Census Commissioner;2011 [cited 2023 July 25]. Available from: https://censusindia.gov.in/nada/index.php/catalog/42611.
27. Singh R, Sharma SC, Mittal R, Sharma A. Traumatic spinal cord injuries in Haryana: an epidemiological study. Indian J Community Med. 2003; 28:184–6.
28. Mittal S, Rana A, Ahuja K, Ifthekar S, Sarkar B, Kandwal P. Pattern of spine fracture in Sub-Himalayan region: A prospective study. J Clin Orthop Trauma. 2021; 15:27–32.
29. Cripps RA, Lee BB, Wing P, Weerts E, Mackay J, Brown D. A global map for traumatic spinal cord injury epidemiology: towards a living data repository for injury prevention. Spinal Cord. 2011; 49:493–501.
30. Bajracharya S, Singh M, Singh GK, Shrestha BP. Clinico-epidemiological study of spinal injuries in a predominantly rural population of eastern Nepal: a 10 years’ analysis. Indian J Orthop. 2007; 41:286–9.
31. Birua GJS, Munda VS, Murmu NN. Epidemiology of spinal injury in North East India: a retrospective study. Asian J Neurosurg. 2018; 13:1084–6.
32. Ahuja CS, Badhiwala JH, Fehlings MG. "Time is spine": the importance of early intervention for traumatic spinal cord injury. Spinal Cord. 2020; 58:1037–9.
33. Ahn H, Singh J, Nathens A, MacDonald RD, Travers A, Tallon J, et al. Pre-hospital care management of a potential spinal cord injured patient: a systematic review of the literature and evidence-based guidelines. J Neurotrauma. 2011; 28:1341–61.
34. Perry SD, McLellan B, McIlroy WE, Maki BE, Schwartz M, Fernie GR. The efficacy of head immobilization techniques during simulated vehicle motion. Spine (Phila Pa 1976). 1999; 24:1839–44.
35. Golestani A, Shobeiri P, Sadeghi-Naini M, Jazayeri SB, Maroufi SF, Ghodsi Z, et al. Epidemiology of traumatic spinal cord injury in developing countries from 2009 to 2020: a systematic review and meta-analysis. Neuroepidemiology. 2022; 56:219–39.
Full Text Links
  • ARM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr