Incidence of nontraumatic spinal cord injury: a Spanish cohort study (1972-2008)

Abstract

Objectives: To assess the incidence of nontraumatic spinal cord injury (SCI) in a determined catchment area in Spain, and to evaluate clinical presentations and trends over time.

Design: Population-based case series study between January 1972 and December 2008 [corrected].

Setting: A hospital with a specialized SCI unit in a delimited health area in Spain.

Participants: Hospital inpatients and outpatients with nontraumatic SCI.

Interventions: Not applicable.

Main outcome measures: Age- and sex-specific incidence rates.

Results: An adjusted incidence rate of 11.4 per million population was found for this region (12.3 for males, 10.4 for females). A total of 541 cases (53% male) were reported over the 37-year study period. Incidence rates increased with age, with a peak in the 60- to 69-year age group. Tumors were the major cause of SCI. Most of the lesions were at the thoracic level, and C and D were the most frequently observed American Spinal Injury Association grades.

Conclusions: Nontraumatic SCI shows a relatively even sex distribution and tends to affect older adults. Injuries are mainly attributable to age-related conditions and result mostly in incomplete lesions, which present with paraplegia. This study revealed that although incidence rates for nontraumatic SCI are similar to those previously reported for traumatic SCI in the same area and during the same period, demographic and clinical characteristics are different. These findings have important implications regarding the delivery of rehabilitation and support services to this group of patients, and suggest the need for health policies that involve improved care and prevention resources.