Abstract
Study design
Retrospective epidemiological study.
Objectives
Since the causes and incidences of traumatic spinal cord injury (TSCI) in each country change over time, up-to-date epidemiological studies are required for countermeasures against TSCI. However, no nationwide survey in Japan has been conducted for about 30 years. The purpose of this study was therefore to investigate the recent incidence and characteristics of TSCI in Japan.
Setting
Japan
Methods
Survey sheets were sent to all hospitals (emergency and acute care hospitals) that treated TSCI persons in Japan in 2018 and case notes were retrospectively reviewed. Frankel grade E cases were excluded from analysis.
Results
The response rate was 74.4% (2804 of 3771 hospitals). The estimated annual incidence of TSCI excluding Frankel E was 49 per million, with a median age of 70.0 years and individuals in their 70s as the largest age group. Male-to-female ratio was 3:1. Cervical cord injuries occurred in 88.1%. Frankel D was the most frequent grade (46.3%), followed by Frankel C (33.0%). The most frequent cause was fall on level surface (38.6%), followed by traffic accident (20.1%). The proportion of fall on level surface increased with age. TSCI due to sports was the most frequent cause in teenagers (43.2%).
Conclusions
This nationwide survey in Japan showed that estimated incidence of TSCI, rate of cervical cord injury, and incomplete injury by falls appear to be increasing with the aging of the population.
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Data availability
The datasets used in this study are publicly available.
Change history
02 September 2020
This article has had values in Table 1 and Table 4 updated. These updates do not affect the integrity of the data, but improve the clarity of the tables.
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Acknowledgements
The authors wish to thank all doctors (Drs Satoko Matsumoto, Hiroshi Taneichi, Satoshi Inami, Hirotaka Chikuda, Masao Koda, Katsunori Yoshinaga, Masaya Nakamura, Osahiko Tsuji, Takashi Asazuma, Yoshiyuki Yato, Tsunehiko Konomi, Masahiko Watanabe, Shinji Kimura, Hideaki Nakajima, Toshiyuki Takahashi, Jun Takahashi, Hiroki Oba, Masakazu Takayasu, Eiichi Saitoh, Hideki Nagashima, Tadao Morino, Tadanori Ogata, Takeshi Maeda and Takayoshi Ueta) for their help in data collection.
Funding
This study was supported by Japan Medical Society of Spinal Cord Lesion.
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NM and DK analyzed the data, prepared, and revised paper content. KS, HS, YN, YM, SS, TT, AT, and HT designed this study and collected the data. SK and YS designed and oversaw the study and were responsible for conclusions.
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This study was performed in accordance with the Declaration of Helsinki. However, this study did not require ethics committee approval because information in this study was anonymized in an unlinkable manner before analysis. These methods conform to the Ethical Guidelines for Medical and Health Research Involving Human Subjects in Japan.
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Miyakoshi, N., Suda, K., Kudo, D. et al. A nationwide survey on the incidence and characteristics of traumatic spinal cord injury in Japan in 2018. Spinal Cord 59, 626–634 (2021). https://doi.org/10.1038/s41393-020-00533-0
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DOI: https://doi.org/10.1038/s41393-020-00533-0
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