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Background <p>Spinal cord injuries (SCI) are major contributors to global disability, with high incidence rates, substantial medical costs, and profound long-term impacts. Cervical spinal cord injuries (cSCI), in particular, lead to severe outcomes, making them a critical public health challenge. While the rising global burden of SCI, including cSCI, is well-known, comprehensive and updated epidemiological studies specifically focused on cSCI, especially those that project future trends and analyze regional disparities, remain limited. This study aims to provide novel insights into the evolving burden of cSCI by offering an updated, global analysis using the most recent data and advanced modeling techniques.</p> Methods <p>We used data from the Global Burden of Disease (GBD) 2021 database to analyze the incidence, prevalence, and Years Lived with Disability (YLDs) of cSCI from 1990 to 2021 across 204 countries and territories. The DisMod-MR 2.1 Bayesian meta-regression tool was employed to estimate the burden of cSCI, while inequality analyses were conducted using the Gini coefficient and concentration index. Risk factor attribution was performed using the Comparative Risk Assessment framework. Additionally, Bayesian Age-Period-Cohort (BAPC) analysis was used to predict the future burden of cSCI to 2045.</p> Results <p>While the global incidence of cSCI has increased from 249,122 cases (95% CI: 183,942 to 345,205) in 1990 to 306,568 cases (95% CI: 216,989 to 456,717) in 2021, the age-standardized incidence rate (ASR) has decreased from 4.88 to 3.78 per 100,000 population. This decrease, despite rising absolute numbers, reflects known factors such as improvements in trauma prevention, healthcare access, and better management of degenerative conditions. Regional disparities in cSCI burden and the influence of socio-economic and healthcare inequalities have been highlighted, underscoring the need for targeted interventions. Predictive modeling suggests a continued rise in cSCI incidence, particularly in regions with expanding aging populations.</p> Conclusion <p>This study provides a comprehensive, up-to-date analysis of the global burden of cSCI, including regional disparities and future projections. The findings highlight the urgent need for tailored healthcare interventions and resource allocation strategies, particularly in regions with limited healthcare access. By identifying high-risk populations and regions, this study offers critical insights that can inform future public health policies and interventions to mitigate the growing burden of cSCI.</p>

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Global, regional, and National burdens of cervical spinal cord injuries from 1990 to 2021, findings from global burden of disease study 2021

  • 期刊论文

  • 发表日期：

    2025年8月11日

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  • Kan Wang,
  • Qiqi Wu,
  • Meng-Qi Chen,
  • Chen Jiang,
  • Zhanfei Li

摘要

Background

Spinal cord injuries (SCI) are major contributors to global disability, with high incidence rates, substantial medical costs, and profound long-term impacts. Cervical spinal cord injuries (cSCI), in particular, lead to severe outcomes, making them a critical public health challenge. While the rising global burden of SCI, including cSCI, is well-known, comprehensive and updated epidemiological studies specifically focused on cSCI, especially those that project future trends and analyze regional disparities, remain limited. This study aims to provide novel insights into the evolving burden of cSCI by offering an updated, global analysis using the most recent data and advanced modeling techniques.

Methods

We used data from the Global Burden of Disease (GBD) 2021 database to analyze the incidence, prevalence, and Years Lived with Disability (YLDs) of cSCI from 1990 to 2021 across 204 countries and territories. The DisMod-MR 2.1 Bayesian meta-regression tool was employed to estimate the burden of cSCI, while inequality analyses were conducted using the Gini coefficient and concentration index. Risk factor attribution was performed using the Comparative Risk Assessment framework. Additionally, Bayesian Age-Period-Cohort (BAPC) analysis was used to predict the future burden of cSCI to 2045.

Results

While the global incidence of cSCI has increased from 249,122 cases (95% CI: 183,942 to 345,205) in 1990 to 306,568 cases (95% CI: 216,989 to 456,717) in 2021, the age-standardized incidence rate (ASR) has decreased from 4.88 to 3.78 per 100,000 population. This decrease, despite rising absolute numbers, reflects known factors such as improvements in trauma prevention, healthcare access, and better management of degenerative conditions. Regional disparities in cSCI burden and the influence of socio-economic and healthcare inequalities have been highlighted, underscoring the need for targeted interventions. Predictive modeling suggests a continued rise in cSCI incidence, particularly in regions with expanding aging populations.

Conclusion

This study provides a comprehensive, up-to-date analysis of the global burden of cSCI, including regional disparities and future projections. The findings highlight the urgent need for tailored healthcare interventions and resource allocation strategies, particularly in regions with limited healthcare access. By identifying high-risk populations and regions, this study offers critical insights that can inform future public health policies and interventions to mitigate the growing burden of cSCI.