Demographic profile of patients with TSCI.

Traumatic spinal cord injury (TSCI) causes an insult to the central nervous system, often resulting in devastating temporary or permanent neurological impairment and disability, which places a substantial financial burden on the health-care system. This study aimed to clarify the up-to-date epidemiology and demographics of patients with TSCI treated at the largest SCI center in Japan. Data on all patients admitted to the Spinal Injuries Center with TSCI between May 2005 and December 2021 were prospectively collected using a customized, locally designed SCI database named the Japan Single Center Study for Spinal Cord Injury Database (JSSCI-DB). A total of 1152 patients were identified from the database. The study period was divided into the four- or five-year periods of 2005–2009, 2010–2013, 2014–2017, and 2018–2021 to facilitate the observation of general trends over time. Our results revealed a statistically significant increasing trend in age at injury. Since 2014, the average age of injury has increased to exceed 60 years. The most frequent spinal level affected by the injury was high cervical (C1-C4: 45.8%), followed by low cervical (C5-C8: 26.4%). Incomplete tetraplegia was the most common cause or etiology category of TSCI, accounting for 48.4% of cases. As the number of injuries among the elderly has increased, the injury mechanisms have shifted from high-fall trauma and traffic accidents to falls on level surfaces and downstairs. Incomplete tetraplegia in the elderly due to upper cervical TSCI has also increased over time. The percentage of injured patients with an etiology linked to alcohol use ranged from 13.2% (2005–2008) to 19% (2014–2017). Given that Japan has one of the highest aging populations in the world, epidemiological studies in this country will be very helpful in determining health insurance and medical costs and deciding strategies for the prevention and treatment of TSCI in future aging populations worldwide.

创伤性脊髓损伤（traumatic spinal cord injury, TSCI）会对中枢神经系统造成损伤，常导致严重的暂时性或永久性神经功能障碍与残疾，给医疗保健系统带来沉重的经济负担。
本研究旨在明确日本最大脊髓损伤（spinal cord injury, SCI）中心收治的TSCI患者的最新流行病学特征与人口学资料。
本研究前瞻性收集了2005年5月至2021年12月期间，日本脊髓损伤中心收治的所有TSCI患者的临床数据，所用数据库为本地化定制开发的SCI数据库——日本脊髓损伤单中心研究数据库（Japan Single Center Study for Spinal Cord Injury Database, JSSCI-DB）。
最终从该数据库中共纳入1152例患者。
为便于分析随时间推移的整体变化趋势，本研究将观察周期划分为2005–2009年、2010–2013年、2014–2017年及2018–2021年四个时段，其中2005–2009年为5年周期，其余均为4年周期。
研究结果显示，患者受伤时的年龄呈具有统计学意义的上升趋势；自2014年起，患者的平均受伤年龄已超过60岁。
最常受累的脊髓损伤节段为高位颈椎（C1~C4，占比45.8%），其次为低位颈椎（C5~C8，占比26.4%）。
不完全性四肢瘫是TSCI最常见的病因类型，占所有病例的48.4%。
随着老年人群中TSCI患者数量的增加，损伤诱因已从高坠伤与交通事故转变为平地跌倒与下楼时跌倒。
老年人群中因高位颈椎TSCI导致的不完全性四肢瘫病例数也随时间呈上升趋势。
与饮酒相关的TSCI患者占比从2005–2008年的13.2%上升至2014–2017年的19%。
鉴于日本是全球人口老龄化程度最高的国家之一，针对日本人群的TSCI流行病学研究，将有助于制定医疗保险与医疗费用政策，并为全球未来老龄化人群的TSCI防治策略提供参考依据。