Citation

Kumar R, Lim J, Mekary RA, Rattani A, Dewan MC, Sharif SY, Osorio-Fonseca E, Park KB. World Neurosurg. 2018; 113: e345-e363.

Affiliation

Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.wneu.2018.02.033

PMID

29454115

Abstract

BACKGROUND: Traumatic spinal injury (TSI) results from injury to bony, ligamentous and/or neurological structures of the spinal column and can cause significant morbidity and mortality. The global burden of TSI is poorly understood, so we performed a systematic review and meta-analysis to estimate the global volume of TSI.

METHODS: We performed a systematic review through PubMed, Embase and Cochrane Databases on TSI studies published from 2000 to 2016. Collected data were used to perform a meta-analysis to estimate the annual incidence of TSI across World Health Organization (WHO) regions and World Bank income groups using random effect models. Incorporating global population figures, the annual worldwide volume of TSI was estimated.

RESULTS: A total of 102 studies were included in the systematic review and 19 studies in the meta-analysis. The overall global incidence of TSI was 10.5 cases per 100,000 persons, resulting in an estimated 768,473 [95% CI: 597,213 - 939,732] new cases of TSI annually worldwide. The incidence of TSI was higher in low- and middle-income countries (LMICs) (8.72 per 100,000 persons) compared to high income countries (HICs) (13.69 per 100,000 persons). Road traffic accidents, followed by falls, were the most common mechanism of TSI worldwide. Overall, 48.8% of patients suffering from TSI required a surgery.

CONCLUSION: TSI is a major source of morbidity and mortality throughout the world. Largely preventable mechanisms, including road traffic accidents and falls, are main causes of TSI globally. Further investigation is needed to delineate local and regional TSI incidences and causes, especially in LMICs.

Copyright © 2018 Elsevier Inc. All rights reserved.

Language: en

Keywords

epidemiology; global; incidence; traumatic spinal cord injury; traumatic spinal injury; volume