Traumatic spinal cord injuries on the rise in US

January 27, 2014

The number of serious traumatic spinal cord injuries is on the rise in the United States, and the leading cause no longer appears to be motor vehicle crashes, but falls, new Johns Hopkins research suggests.

The same research shows, moreover, that rates of these injuries—whose symptoms range from temporary numbness to full-blown paralysis—are rising fastest among older people, suggesting that efforts to prevent falls in the elderly could significantly curb the number of spinal injuries.

"We have demonstrated how costly traumatic injury is and how lethal and disabling it can be among older people," says Shalini Selvarajah, M.D., M.P.H., a postdoctoral surgical research fellow at the Johns Hopkins University School of Medicine and leader of the study published online in the Journal of Neurotrauma. "It's an area that is ripe for prevention."

For their study, the Johns Hopkins researchers analyzed a nationally representative sample of 43,137 adults treated in hospital emergency rooms for spinal cord injury in the United States between 2007 and 2009. While the incidence among those aged 18 to 64 ranged from 52.3 per million in 2007 to 49.9 per million in 2009, the incidence per million in those 65 and older increased from 79.4 in 2007 to 87.7 in 2009. Falls were the leading cause of traumatic spinal cord injury over the three-year study period (41.5 percent), followed by (35.5 percent). Fall-related increased during the study period overall. Among the elderly, they increased from 23.6 percent to 30 percent of injuries.

The average age of adults with a traumatic spinal cord injury in a previous study that covered the years 2000 to 2005 was 41; the new study suggests it is now 51.

The investigators say that even when taking into account injury severity and other illnesses experienced by the patients, older adults with traumatic spinal cord injury are four times more likely to die in the emergency room from such an injury compared to younger adults. If they survive and are admitted, they are six times more likely to die during their inpatient stay.

While the researchers say they can't pinpoint the exact reason that falls have surpassed car crashes as a cause of traumatic , they believe it may be a combination of the general aging of the population, the more active lifestyles of many Americans over 65, and airbags and seatbelt laws that allow drivers and passengers to survive crashes.

"We are seeing a changing face in the epidemiology of spinal cord injury," says Edward R. Hammond, M.D., Ph.D., a research associate at the International Center for Spinal Cord Injury at Kennedy Krieger Institute and another of the study's leaders.

Beyond the personal toll of disability and death, spinal cord injuries are a growing financial burden on the health care system, the researchers say. They estimate that from 2007 to 2009, emergency room charges alone for traumatic spinal cord injury patients totaled $1.6 billion. But that is "just the first drop in a long-filling bucket," says Eric B. Schneider, Ph.D., an epidemiologist at the Johns Hopkins University School of Medicine's Center for Surgical Trials and Outcomes Research. Those charges increased by 20 percent over the study period, far more than just the cost of inflation.

The spinal cord injuries captured by the data for this study were those serious enough to land the patient in the and included temporary bruising to severed or permanently damaged cords that cause paralysis, difficulty breathing, an inability to fill and empty the bladder and other motor disabilities.

According to the National Spinal Cord Injury Statistical Center, lifetime costs of care for someone with a serious spinal cord injury can range from $1 million to $5 million, depending on the age of the person at the time of injury and the severity of the injury. Improvements in rehab care are leading to longer life expectancy among patients with spinal cord injury—and bigger medical bills.

"With so much emphasis on trying to reduce health care costs right now, this is another reason why preventing the injury altogether is so vital," Selvarajah says.

A recent campaign by the National Institutes of Health is funding the search for better ways to prevent falls that lead to in the elderly. Schneider says the effort could also lead to a coincidental reduction in traumatic spinal cord injury.

The spinal cord is a long bundle of nerve tissue that sits inside a bony structure called the vertebral column or backbone. It is the conduit that connects the brain to the rest of the body, enabling nearly all of the latter's functions.

Explore further: Patients with spinal cord injuries should be assessed for sleep apnea

Related Stories

Patients with spinal cord injuries should be assessed for sleep apnea

January 15, 2014
A new study suggests that patients with spinal cord injuries could benefit from careful assessment for sleep apnea.

Stem cell scarring aids recovery from spinal cord injury

October 31, 2013
In a new study, researchers at Karolinska Institutet in Sweden show that the scar tissue formed by stem cells after a spinal cord injury does not impair recovery; in fact, stem cell scarring confines the damage. The findings, ...

Does the timing of surgery to treat traumatic spinal cord injury affect outcomes?

October 24, 2013
Performing surgery to take pressure off the spine after a traumatic injury soon after the event could prevent or reverse some of the secondary damage caused by swelling and decreased blood flow to the injured spine. However, ...

Spinal cord treatment offers hope

November 18, 2011
Queensland University of Technology (QUT) researchers have developed a promising new treatment for spinal cord injury in animals, which could eventually prevent paralysis in thousands of people worldwide every year.

Researcher focuses on the repair of spinal cords

November 11, 2013
A spinal cord injury can be a devastating condition, often resulting in life-long disability and a range of secondary complications.

Research offers hope in new treatment for spinal cord injuries

May 3, 2011
Rutgers researchers have developed an innovative new treatment that could help minimize nerve damage in spinal cord injuries, promote tissue healing and minimize pain.

Recommended for you

Nature or nurture? Innate social behaviors in the mouse brain

October 18, 2017
Adult male mice have a simple repertoire of innate, or instinctive, social behaviors: When encountering a female, a male mouse will try to mate with it, and when encountering another male, the mouse will attack. The animals ...

Brain activity predicts crowdfunding outcomes better than self-reports

October 18, 2017
Surveys and self-reports are a time-honored way of trying to predict consumer behavior, but they have limitations. People often give socially desirable answers or they simply don't know or remember things clearly.

Brain-machine interfaces to treat neurological disease

October 18, 2017
Since the 19th century at least, humans have wondered what could be accomplished by linking our brains – smart and flexible but prone to disease and disarray – directly to technology in all its cold, hard precision. Writers ...

Changing stroke definitions is causing chaos, warns professor

October 18, 2017
Proposals to change the definitions of stroke and related conditions are causing confusion and chaos in clinical practice and research, a Monash University associate professor has warned.

Navigational view of the brain thanks to powerful X-rays

October 18, 2017
If brain imaging could be compared to Google Earth, neuroscientists would already have a pretty good "satellite view" of the brain, and a great "street view" of neuron details. But navigating how the brain computes is arguably ...

'Wasabi receptor' for pain discovered in flatworms

October 18, 2017
A Northwestern University research team has discovered how scalding heat and tissue injury activate an ancient "pain" receptor in simple animals. The findings could lead to new strategies for analgesic drug design for the ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.