Department of Spine Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, GuangzhouGuangdong, 510630, China.
Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou, 510630, Guangdong, China.
BMC Med. 2024 Jul 8;22(1):285. doi: 10.1186/s12916-024-03514-9.
This study employs systematic review and meta-analysis to explore the incidence and characteristics of spinal cord injury (SCI) between 2000 and 2021, aiming to provide the most recent and comprehensive data support for the prevention, diagnosis, treatment, and care of SCI.
Systematic searches were conducted on epidemiological studies of SCI published between January 1, 2000, and March 29, 2024. Meta-analysis, subgroup analysis, meta-regression, publication bias detection, and literature quality assessment were extensively utilized.
The pooled results from 229 studies indicated that the overall incidence rate of SCI was 23.77 (95% CI, 21.50-26.15) per million people, with traumatic spinal cord injuries (TSCI) at a rate of 26.48 (95% CI, 24.15-28.93) per million people, and non-traumatic spinal cord injuries (NTSCI) at a rate of 17.93 (95% CI, 13.30-23.26) per million people. The incidence of TSCI exhibited a marked age-related increase and was significantly higher in community settings compared to hospital and database sources. Males experienced TSCI at a rate 3.2 times higher than females. Between 2000 and 2021, the incidence of TSCI remained consistently high, between 20 and 45 per million people, whereas NTSCI incidence has seen a steady rise since 2007, stabilizing at a high rate of 25-35 per million people. Additionally, the incidence of TSCI in developing countries was notably higher than that in developed countries. There were significant differences in the causes of injury, severity, injury segments, gender, and age distribution among the TSCI and NTSCI populations, but the proportion of male patients was much higher than that of female patients. Moreover, study quality, country type, and SCI type contributed to the heterogeneity in the meta-analysis.
The incidence rates of different types of SCI remain high, and the demographic distribution of SCI patients is changing, indicating a serious disease burden on healthcare systems and affected populations. These findings underscore the necessity of adopting targeted preventive, therapeutic, and rehabilitative measures based on the incidence and characteristics of SCI.
本研究采用系统评价和荟萃分析的方法，探讨了 2000 年至 2021 年间脊髓损伤（SCI）的发病率和特征，旨在为 SCI 的预防、诊断、治疗和护理提供最新和最全面的数据支持。
对 2000 年 1 月 1 日至 2024 年 3 月 29 日发表的 SCI 流行病学研究进行了系统检索。广泛应用荟萃分析、亚组分析、荟萃回归、发表偏倚检测和文献质量评估。
229 项研究的汇总结果表明，SCI 的总体发病率为每百万人 23.77（95%CI，21.50-26.15），外伤性脊髓损伤（TSCI）为每百万人 26.48（95%CI，24.15-28.93），非外伤性脊髓损伤（NTSCI）为每百万人 17.93（95%CI，13.30-23.26）。TSCI 的发病率与年龄呈显著相关，且在社区环境中的发病率明显高于医院和数据库来源。男性 TSCI 的发病率是女性的 3.2 倍。2000 年至 2021 年，TSCI 的发病率一直保持在较高水平，在 20 至 45 每百万人之间，而 NTSCI 的发病率自 2007 年以来稳步上升，稳定在 25-35 每百万人之间。此外，发展中国家 TSCI 的发病率明显高于发达国家。TSCI 和 NTSCI 人群在损伤原因、严重程度、损伤节段、性别和年龄分布等方面存在显著差异，但男性患者比例明显高于女性患者。此外，研究质量、国家类型和 SCI 类型对荟萃分析的异质性有影响。
不同类型 SCI 的发病率仍然很高，SCI 患者的人口统计学分布正在发生变化，这表明医疗系统和受影响人群面临着严重的疾病负担。这些发现强调了根据 SCI 的发病率和特征采取有针对性的预防、治疗和康复措施的必要性。
