Abstract
Study design:
Cohort study
Objectives:
The objective of this study was to characterize the incidence of spinal cord injury (SCI) within the population of the United States military from 2000–2009. This investigation also sought to define potential risk factors for the development of SCI.
Setting:
The population of the United States military from 2000–2009.
Methods:
The Defense Medical Epidemiology Database was queried for the years 2000–2009 using the International Classification of Diseases, Ninth Revision, Clinical Modification codes for SCI (806.0, 806.1, 806.2, 806.3, 806.4, 806.5, 806.8, 806.9, 952.0, 952.1, 952.2, 952.8, 952.9). The raw incidence of SCI was calculated and unadjusted incidence rates were generated for the risk factors of age, sex, race, military rank and branch of service. Adjusted incidence rate ratios were subsequently determined via multivariate Poisson regression analysis that controlled for other factors in the model and identified significant independent risk factors for SCI.
Results:
Between 2000 and 2009, there were 5928 cases of SCI among a population at-risk of 13 813 333. The raw incidence of SCI within the population was 429 per million person-years. Male sex, white race, enlisted personnel and service in the Army, Navy or Marine Corps were found to be significant independent risk factors for SCI. The age groups 20–24, 25–29 and >40 were also found to be at significantly greater risk of developing the condition.
Conclusions:
This study is one of the few investigations to characterize the incidence, epidemiology and risk factors for SCI within the United States. Results presented here may represent the best-available evidence for risk factors of SCI in a large and diverse American cohort.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Couris CM, Guilcher SJT, Munce SEP, Fung K, Craven BC, Verrier M et al. Characteristics of adults with incident traumatic spinal cord injury in Ontario, Canada. Spinal Cord 2010; 48: 39–44.
Dryden DM, Saunders LD, Rowe BH, May LA, Yiannakoulias N, Svenson LW et al. The epidemiology of traumatic spinal cord injury in Alberta, Canada. Can J Neurol Sci 2003; 30: 113–121.
Hu R, Mustard CA, Burns C . Epidemiology of incident spinal fracture in a complete population. Spine 1996; 21: 492–499.
Pickett GE, Campos-Benitez M, Keller JL, Duggal N . Epidemiology of traumatic spinal cord injury in Canada. Spine 2006; 31: 799–805.
Acton PA, Farley T, Freni LW, Ilegbodu VA, Sniezek JE, Wohlleb JC . Traumatic spinal cord injury in Arkansas, 1980 to 1989. Arch Phys Med Rehabil 1993; 74: 1035–1040.
Burke DA, Linden RD, Zhang YP, Maiste AAC, Shields CB . Incidence rates and populations at risk for spinal cord injury: a regional study. Spinal Cord 2001; 39: 274–278.
Griffin MR, Opitz JL, Kurland LT, Ebersold MJ, O’fallon WM . Traumatic spinal cord injury in Olmstead County, Minnesota, 1935–1981. Am J Epidemiol 1985; 121: 884–895.
Price C, Makintubee S, Hernodon W, Istre GR . Epidemiology of traumatic spinal cord injury and acute hospitalization and rehabilitation charges for spinal cord injuries in Oklahoma, 1988–1990. Am J Epidemiol 1994; 139: 37–47.
Surkin J, Gilbert BJ, Harkey III HL, Sniezek J, Currier M . Spinal cord injury in Mississippi. Findings and evaluation, 1992–1994. Spine 2000; 25: 716–721.
Divanoglou A, Levi R . Incidence of traumatic spinal cord injury in Thessaloniki, Greece and Stockholm, Sweden: a prospective population-based study. Spinal Cord 2009; 47: 796–801.
Hagen EM, Eide GE, Rekand T, Gilhus NE, Gronning M . A 50-year follow-up of the incidence of traumatic spinal cord injuries in Western Norway. Spinal Cord 2010; 48: 313–318.
Ning GZ, Yu TQ, Feng SQ, Zhou XH, Ban DX, Liu Y et al. Epidemiology of traumatic spinal cord injury in Tianjin, China. Spinal Cord 2011; 49: 386–390.
Rahimi-Movaghar V, Saadat S, Rasouli MR, Ganji S, Ghahramani M, Zarei MR et al. Prevalence of spinal cord injury in Tehran, Iran. J Spinal Cord Med 2009; 32: 428–431.
Army Medical Surveillance Activity. Defense Medical Epidemiological Database (DMED) Users Guide. Version 3.6.4. March 2004. http://www.afhsc.mil/viewDocument?file=DMED_Userguide/DMEDUsersGuide364.pdf Accessed 7 March, 2010.
Owens BD, Dawson L, Burks R, Cameron KL . Incidence of shoulder dislocation in the United States military: demographic considerations from a high-risk population. J Bone Joint Surg Am 2009; 91: 791–796.
Knox J, Orchowski J, Belmont Jr PJ, Scher D, Burks R, Owens B . Incidence and risk factors for low back pain in active duty military over a 10 year period. Spine J 2009; 9 (10S): 118S–119S.
Clark JY, Thompson IM . Military rank as a measure of socioeconomic status and survival from prostate cancer. South Med J 1994; 87: 1141–1144.
Jackson AB, Dijkers M, DeVivo M, Poczatek RB . A demographic profile of new traumatic spinal cord injuries: change and stability over 30 years. Arch Phys Med Rehabil 2004; 85: 1740–1748.
van den Berg ME, Castellote JM, Mahillo-Fernandez I, de Pedro-Cuesta J . Incidence of spinal cord injury worldwide: a systematic review. Neuroepidemiology 2010; 34: 184–192.
United States Census Bureau. Population and Household Economic Topics. http://www.census.gov/population/www/ Accessed 7 September, 2010.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Disclaimer: All authors are employees of the US federal government and the United States Army. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of Defense or United States government.
Rights and permissions
About this article
Cite this article
Schoenfeld, A., McCriskin, B., Hsiao, M. et al. Incidence and epidemiology of spinal cord injury within a closed American population: the United States military (2000–2009). Spinal Cord 49, 874–879 (2011). https://doi.org/10.1038/sc.2011.18
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sc.2011.18
