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Epidemiologic changes in nontraumatic spinal cord injury for the last 30 years (1990–2019) in South Korea

Subjects

Abstract

Study design

Retrospective descriptive study.

Objectives

To summarize epidemiologic data on nontraumatic spinal cord injury (NTSCI) for the last 30 years and compare these findings to data from individuals with traumatic spinal cord injury (TSCI).

Setting

National Rehabilitation Center affiliated with the Ministry of Health and Welfare in Korea.

Methods

The medical records of 948 individuals with NTSCIs were retrospectively reviewed. Three groups were created based on onset period (1990–1999, 2000–2009, 2010–2019) and six groups based on age (≤15, 16–30, 31–45, 46–60, 61–75, and ≥76 years). Pearson’s chi-square and analysis of variance tests were used for statistical analysis.

Results

The male-to-female ratio was 1.30:1 for NTSCI individuals and 3.47:1 for TSCI individuals. The mean age (standard deviation [SD]) at the time of injury increased from 38.7 (SD = 18.1) years in the 1990s to 55.5 (SD = 16.6) years in the 2010s (F = 44.597, p ≤ 0.001). Vertebral column degenerative disorder was the primary cause of injury in 28.9% of the cases, and the most common neurologic level was T12-L2. Paraplegia occurred in 74.6% of cases, and tetraplegia in 25.4% of cases. The proportion of NTSCI individuals increased from 11.2% to 29.3% during the observation period.

Conclusions

The proportion of NTSCI among total spinal cord injuries has increased in Korea over the last 30 years (1990–2019). Compared to individuals with TSCI, those with NTSCI had a higher age at onset, with different male-to-female ratios. Our study is the most comprehensive investigation of NTSCI in Korea, and our findings can inform research directions and medical guidelines.

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Fig. 1: Trends in age distribution among NTSCI individuals.
Fig. 2: Trends in grouped etiology by year of injury.

Data availability

Although the data for this study are not publicly available, data will be made available to other researchers upon reasonable request.

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Author contributions

BSL was responsible for designing the review protocol, conducting the search, and screening potentially eligible studies. OYK and DHH were responsible for updating reference lists and creating tables and figures. All authors (BSL, OYK, and DHH) were responsible for writing the protocol and report, extracting and analyzing data, interpreting results, and approving the final version of the manuscript.

Funding

International spinal cord injury survey (InSCI) – comparative analysis between the countries of the Western Pacific Region (WPR) spinal cord injury database.

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Correspondence to Daehoon Ham.

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Competing interests

The authors declare no competing interests.

Ethical approval

We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research. The Ethics Committee of the Institutional Review Board of the National Rehabilitation Center in South Korea approved this study (approval number: NRC-2019-04-025) and waived the requirement for informed consent because of the retrospective design of this study.

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Lee, BS., Kim, O. & Ham, D. Epidemiologic changes in nontraumatic spinal cord injury for the last 30 years (1990–2019) in South Korea. Spinal Cord 60, 268–273 (2022). https://doi.org/10.1038/s41393-021-00695-5

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