Liu Wei, Samuhaer Azhati, Lin Kunpeng, Li Mingchen, Zang Chunyu, Liu Hongwei, Fan Haixiu, Shi Ke, Li Donghai
Department of Orthopedics, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, Shanxi Province, China.
School of Education, Beijing Sport University, Beijing, China.
J Orthop Surg Res. 2025 Jul 15;20(1):657. doi: 10.1186/s13018-025-05985-9.
Cervical spinal cord injury (CSCI) and subcervical spinal cord injury (SSCI) cause substantial motor, sensory, and autonomic dysfunction, with traumatic and non-traumatic etiologies. CSCI (C1-C8) and SSCI (T1-L1) impose severe individual and societal burdens. This study assessed global trends in SCI incidence, prevalence, and years lived with disability (YLDs) from 1990 to 2021.
Data were drawn from the Global Burden of Disease (GBD) 2021 study. CSCI and SSCI cases were stratified by age, sex, and Socio-demographic Index (SDI). Age-standardized rates (ASR) and estimated annual percentage changes (EAPC) were calculated. Future trends (2022-2050) were projected using ARIMA modeling.
Our analysis revealed clear age-related patterns in SCI burden. Both CSCI and SSCI incidence, prevalence, and YLDs increased with advancing age, with CSCI predominantly affecting middle-aged adults and SSCI rising significantly among the elderly. Males consistently showed higher rates of CSCI and SSCI across both injury types, and significant sex-based differences were observed in YLDs. High-SDI regions experienced gradual decreases in ASR for CSCI, while low-SDI regions exhibited rapid increases in YLDs associated with CSCI, indicating a disparity in healthcare resource allocation. The growth rate of CSCI and SSCI burden was notably higher in low and middle-SDI countries, particularly for SSCI.
Although the overall burden of CSCI and SSCI is stabilizing or declining in certain regions, the global YLDs continue to rise, driven by population aging and insufficient healthcare infrastructure in low-SDI regions. CSCI lead to greater disability, and persistent gender and regional disparities highlight the need for targeted, equitable prevention and rehabilitation strategies.
颈脊髓损伤（CSCI）和颈下脊髓损伤（SSCI）会导致严重的运动、感觉和自主神经功能障碍，其病因包括创伤性和非创伤性。颈脊髓损伤（C1-C8）和颈下脊髓损伤（T1-L1）给个人和社会带来沉重负担。本研究评估了1990年至2021年脊髓损伤发病率、患病率和残疾生活年数（YLDs）的全球趋势。
数据来自《2021年全球疾病负担》（GBD）研究。颈脊髓损伤和颈下脊髓损伤病例按年龄、性别和社会人口指数（SDI）进行分层。计算年龄标准化率（ASR）和估计年百分比变化（EAPC）。使用自回归积分移动平均（ARIMA）模型预测未来趋势（2022-2050年）。
我们的分析揭示了脊髓损伤负担中明显的年龄相关模式。颈脊髓损伤和颈下脊髓损伤的发病率、患病率和残疾生活年数均随年龄增长而增加，颈脊髓损伤主要影响中年成年人，而颈下脊髓损伤在老年人中显著上升。在这两种损伤类型中，男性的颈脊髓损伤和颈下脊髓损伤发生率始终较高，并且在残疾生活年数方面观察到显著的性别差异。高社会人口指数地区颈脊髓损伤的年龄标准化率逐渐下降，而低社会人口指数地区与颈脊髓损伤相关的残疾生活年数迅速增加，表明医疗资源分配存在差异。中低收入国家颈脊髓损伤和颈下脊髓损伤负担的增长率明显更高，尤其是颈下脊髓损伤。
尽管在某些地区颈脊髓损伤和颈下脊髓损伤的总体负担正在稳定或下降，但由于人口老龄化和低社会人口指数地区医疗基础设施不足，全球残疾生活年数仍在继续上升。颈脊髓损伤导致更大的残疾，持续存在的性别和地区差异凸显了制定有针对性的、公平的预防和康复策略的必要性。
