Over the past four decades, there have been progressive changes in the epidemiology of traumatic spinal cord injury (tSCI). We assessed trends in demographic and injury-related variables in traumatic cervical spinal cord injury (tCSCI) patients over an 18-year period at a single Level I trauma center. We included all magnetic resonance imaging–confirmed tCSCI patients ≥15 years of age for years 2001–2018. Among 1420 patients, 78.3% were male with a mean age 51.5 years. Etiology included falls (46.9%), motor vehicle collisions (MVCs; 34.2%), and sports injuries (10.9%). Median American Spinal Injury Association (ASIA) Motor Score (AMS) was 44, complete tCSCI was noted in 29.6% of patients, fracture dislocations were noted in 44.7%, and median intramedullary lesion length (IMLL) was 30.8 mm (complete injuries 56.3 mm and incomplete injuries 27.4 mm). Over the study period, mean age and proportion of falls increased (p < 0.001) whereas proportion attributable to MVCs and sports injuries decreased (p < 0.001). Incomplete injuries, AMS, and the proportion of patients with no fracture dislocations increased whereas complete injuries decreased significantly. IMLL declined (p = 0.17) and proportion with hematomyelia did not change significantly. In adjusted regression models, increase in age and decreases in prevalence of MVC mechanism and complete injuries over time remained statistically significant. Changes in demographic and injury-related characteristics of tCSCI patients over time may help explain the observed improvement in outcomes. Further, improved clinical outcomes and drop in IMLL may reflect improvements in initial risk assessment and pre-hospital management, advances in healthcare delivery, and preventive measures including public education.

中文翻译：

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外伤性颈脊髓损伤的人口统计学趋势和损伤严重程度标志物

在过去的四年中，创伤性脊髓损伤 (tSCI) 的流行病学发生了渐进性变化。我们在单个一级创伤中心评估了 18 年期间外伤性颈脊髓损伤 (tCSCI) 患者的人口统计学和损伤相关变量的趋势。我们纳入了 2001-2018 年所有 15 岁以上的磁共振成像证实的 tCSCI 患者。在 1420 名患者中，78.3% 为男性，平均年龄 51.5 岁。病因包括跌倒（46.9%）、机动车碰撞（MVC；34.2%）和运动损伤（10.9%）。美国脊髓损伤协会 (ASIA) 运动评分 (AMS) 中位数为 44，29.6% 的患者出现完全性 tCSCI，44.7% 的患者出现骨折脱位，髓内病变长度 (IMLL) 中位数为 30.8 毫米（完全损伤 56.3 毫米）和不完全损伤 27.4 毫米）。p  < 0.001）而归因于 MVC 和运动损伤的比例下降（p  < 0.001）。不完全性损伤、AMS 和无骨折脱位的患者比例增加，而完全性损伤显着减少。IMLL 下降 ( p = 0.17）和与骨髓血肿的比例没有显着变化。在调整后的回归模型中，随着时间的推移，年龄的增加和 MVC 机制和完全损伤的患病率下降仍然具有统计学意义。随着时间的推移，tCSCI 患者的人口统计学和损伤相关特征的变化可能有助于解释观察到的结果改善。此外，临床结果的改善和 IMLL 的下降可能反映了初始风险评估和院前管理的改善、医疗保健服务的进步以及包括公共教育在内的预防措施。