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article · The Lancet Neurology

Global, regional, and national burden of spinal cord injury, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

2023326 citationsOpen accessMenoufia University

In plain language

A systematic analysis of global data from 1990 to 2019 reveals the significant and increasing burden of spinal cord injury (SCI). In 2019, 20.6 million individuals worldwide were living with SCI, with 0.9 million new cases and 6.2 million years lived with disability. While age-standardised rates showed only minor changes, the absolute numbers for prevalence, incidence, and years lived with disability increased substantially over the period. Incidence peaks in young adults aged 15-19, whereas prevalence and years lived with disability peak around 45-54 years. SCI rates are consistently higher in men than women. Falls and road injuries were the leading causes of SCI globally in 2019, with neck-level injuries being more common.

Key takeaways

  • In 2019, 20.6 million people globally were living with spinal cord injury, with 0.9 million new cases and 6.2 million years lived with disability.
  • From 1990 to 2019, the absolute number of spinal cord injury cases, prevalence, and years lived with disability increased significantly worldwide.
  • Spinal cord injury incidence is highest in young adults (15-19 years), while prevalence and years lived with disability peak in middle age (45-54 years).
  • Men consistently experience higher rates of spinal cord injury than women globally.
  • Falls and road injuries were identified as the two primary causes of spinal cord injury in 2019.

Why it matters

This research provides a comprehensive global overview of spinal cord injury, highlighting its increasing burden and key demographic patterns. Understanding these trends is crucial for public health planning, resource allocation, and developing targeted prevention strategies to reduce the significant long-term disability associated with this condition.

Commercialisation angle

The abstract focuses on epidemiological data and policy implications, providing foundational information for public health interventions and policy development. It does not indicate an application pathway for commercialisation of specific products or technologies.

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Abstract

BACKGROUND: Spinal cord injury (SCI) is a major cause of health loss due to premature mortality and long-term disability. We aimed to report on the global, regional, and national incidence, prevalence, and years of life lived with disability (YLDs) for SCI from 1990 to 2019, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS: Using GBD 2019 data pooled in DisMod-MR 2.1, a Bayesian meta-regression tool, we systematically derived numbers and age-standardised rate changes with 95% uncertainty intervals (95% UIs) for the incidence, prevalence, and YLDs for SCI from 1990 to 2019 for the whole world, 21 GBD regions, and 204 countries and territories. We report trends based on age, sex, year, cause of injury, and level of injury. FINDINGS: Globally, 20·6 million (95% UI 18·9 to 23·6) individuals were living with SCI in 2019. The incidence of SCI was 0·9 million (0·7 to 1·2) cases with an estimated 6·2 million (4·5 to 8·2) YLDs. SCI rates increased substantially from 1990 to 2019 for global prevalence (81·5%, 74·2 to 87·1), incidence (52·7%, 30·3 to 69·8), and YLDs (65·4%, 56·3 to 76·0). However, global age-standardised rates per 100 000 population showed small changes in prevalence (5·8%, 2·6 to 9·5), incidence (-6·1%, -17·2 to 1·5), and YLDs (-1·5%, -5·5 to 3·2). Data for 2019 shows that the incidence of SCI increases sharply until age 15-19 years, where it remains reasonably constant until 85 years of age and older. By contrast, prevalence and YLDs showed similar patterns to each other, with one peak at around age 45-54 years. The incidence, prevalence, and YLDs of SCI have consistently been higher in men than in women globally, with a slight and steady increase for both men and women from 1990 to 2019. Between 1990 and 2019, SCI at neck level was more common than SCI below neck level in terms of incidence (492 thousand [354 to 675] vs 417 thousand [290 to 585]), prevalence (10·8 million [9·5 to 13·9] vs 9·7 million [9·2 to 10·4]), and YLDs (4·2 million [3·0 to 5·8] vs 1·9 million [1·3 to 2·5]). Falls (477 thousand [327 to 683] cases) and road injuries (230 thousand [122 to 389] cases) were the two leading causes of SCI globally in 2019. INTERPRETATION: Although age-standardised rates of incidence, prevalence, and YLDs for SCI changed only slightly, absolute counts increased substantially from 1990 to 2019. Geographical heterogeneity in demographic, spatial, and temporal patterns of SCI, at both the national and regional levels, should be considered by policy makers aiming to reduce the burden of SCI. FUNDING: Bill & Melinda Gates Foundation.

Research topics

  • Spinal Cord Injury Research
  • Prosthetics and Rehabilitation Robotics
  • Nerve injury and regeneration

Sustainable Development Goals

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DOI: 10.1016/s1474-4422(23)00287-9

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