The number of people in the United States who are alive today and who
have SCI has been estimated to be between 721 and 906 per million
population. This corresponds to between 183,000 and 203,000 people.
Age at injury:
SCI primarily affects young adults. Fifty-six percent of SCIs occur
among persons in the 16 to 30 year age group and the average age at
injury is 31.7 years. Since 1973, there has been an increase in the mean
age at time of injury. Those who were injured before 1979 had a mean age
of 28.6 while those injured after 1990 had a mean age of 34.8 years.
Another trend is an increase in the proportion of those who were at
least 61 years of age at injury. In the 1970's, persons older than 60
years of age at injury comprised 4.7% of the database. Since 1990, this
has increased to 9.7%. This trend is not surprising, since the median age
of the general population has increased from 27.9 years to 33.1 years
during the same time period.
Overall, 81.8% of all persons in the national database are male. This
greater than four-to-one male to female ratio has varied little over the
A significant trend over time has been observed in the racial
distribution of persons in the Model System database. Among persons
injured between 1973 and 1978, 77.5% of persons in the database were
Caucasian, 13.5% were African-American, 6% were Hispanic, 2% were
American Indian and 0.8% were Asian. However, among those injured since
1990 only 57.4% were Caucasian, while 28.4% were African-American, 9.2%
were Hispanic, 0.4% were American Indian, 1.9% were Asian (and 0.4% were
level and extent
Persons with tetraplegia (51.9%) have sustained injuries to one of the
eight cervical segments of the spinal cord; those with paraplegia
(46.7%) have lesions in the thoracic, lumbar, or sacral regions of the
spinal cord. For the remaining persons, 0.7% recover prior to discharge
and 0.7% are persons for whom this information is not available.
Since 1990, the most frequent
neurologic category is incomplete tetraplegia (29.6%), followed by
complete paraplegia (28.1%), incomplete paraplegia (21.5%) and complete
tetraplegia (18.6%). Trends, over time, indicate an increasing proportion
of persons with incomplete paraplegia and a decreasing proportion of
persons with complete tetraplegia.
Since 1990, motor vehicle crashes were the leading cause of SCI
injuries reported. The next largest contributor were acts of violence
(primarily gunshot wounds), followed by falls and recreational sporting
activities. The proportion of injuries due to motor vehicle crashes and
sporting activities have declined while the proportion of injuries from
acts of violence has increased steadily since 1973.
Motor vehicle accidents
are the leading cause of SCI (44%), followed by acts of violence
(24%), falls (22%), sports (8%), and other causes (2%).
2/3 of the sports-related
injuries are from diving.
Falls overtake motor
vehicles as the leading cause after age 45.
Acts of violence and
sports cause less injuries as age increases.
Acts of violence have
overtaken falls as the second most common source of spinal cord
Lifetime costs: Average yearly health care and living
expenses and the estimated lifetime costs that are directly attributable
to SCI vary greatly according to severity of injury:
|Severity of Injury
||Each Subsequent Year
Functional at any Level
Estimated lifetime costs by
Age at Injury (discounted at 4%)
|Severity of Injury
||Age at Injury
||25 years old
||50 years old
|High Tetraplegia (C1-C4
|Low Tetraplegia (C5-C8)
|Incomplete Motor Functional at any
These figures do not include
any indirect costs such as losses in wages, fringe benefits and
productivity which could average almost $46,000 but vary substantially
based on education, severity of injury and pre-injury employment
Life expectancy is the average remaining years of life
for an individual. Life expectancies for persons with SCI continue to
increase, but are still somewhat below life expectancies for those with
no spinal cord injury. Mortality rates are significantly higher during
the first year after injury than during subsequent years, particularly
for severely injured persons.
who survive the first 24 hours
|Age at Injury
||Motor Functional at any
||Low Tetra (C5-C8)
||High Tetra (C1-C4)
at any Level
surviving at least 1 year post-injury
|Age at Injury
||Motor Functional at any
||Low Tetra (C5-C8)
||High Tetra (C1-C4)
at any Level
Cause of death:
In years past, the leading cause of death among persons
with SCI was renal failure. Today, however, significant advances in
urologic management have resulted in dramatic shifts in the leading
causes of death. Persons enrolled in the National SCI Database since its
inception in 1973 have now been followed for 25 years after injury.
During that time, the causes of death that appear to have the greatest
impact on reduced life expectancy for this population are pneumonia,
pulmonary emboli and septicemia.
More than half (63.5%) of those persons with SCI reported being employed
at the time of their injury. The post-injury employment picture is
better among persons with paraplegia than among their tetraplegic
counterparts. By post-injury year 10, 35.4% of persons with paraplegia
are employed, while 23.1% of those with tetraplegia are employed during
the same year.
Today 91.7% of all persons with SCI who are discharged alive from the
system are sent to a private, non institutional residence (in most cases
their homes before injury.) Only 4.6% are discharged to nursing homes.
The remaining are discharged to hospitals, group living situations or
Considering the youthful age of most persons with SCI, it is not
surprising that most (53.6%) are single when injured. Among those who
were married at the time of injury, as well as those who marry after
injury, the likelihood of their marriage remaining intact is slightly
lower when compared to the uninjured population. The likelihood of
getting married after injury is also reduced.
Length of stay:
Overall, average days hospitalized in the acute care unit for those who
enter a Model System immediately following injury has declined from 26
days in 1974 to 14 days in 1997. Similar downward trends are noted for
days in the rehab unit, from 115 days to 46 days. Overall, mean days
hospitalized (during acute care and rehab) were greater for persons with
neurologically complete injuries.
The above information was taken directly from the Foundation
for Spinal Cord Injury Prevention web site. It is meant for
educational purposes only.
National Spinal Cord
Injury Statistical Center (NSCISC)
is Spinal Cord Injury?
Spinal Cord Injury (SCI) is damage to the spinal cord that results in a
loss of function such as mobility or feeling. Frequent causes of damage
are trauma (car accident, gunshot, sports accidents, falls, etc.)
or disease (polio, spina bifida, spinal tumours, etc.). The spinal cord
does not have to be severed in order for a loss of functioning to occur.
In fact, in most people with SCI, the spinal cord is intact, but the
damage to it results in loss of functioning. SCI is very different from
other back injuries such as ruptured disks, or pinched nerves.
A person can "break their back or neck" yet not sustain a
spinal cord injury if only the bones around the spinal cord (the
vertebrae) are damaged, but the spinal cord is not affected. In these
situations, the individual may not experience paralysis after the bones
is the spinal cord and the vertebra?
The spinal cord is about 18 inches long and extends from the base of the
brain, down the middle of the back, to about the waist. The nerves that
lie within the spinal cord are upper motor neurons (UMNs) and their
function is to carry the messages back and forth from the brain to the
spinal nerves along the spinal tract. The spinal nerves that
branch out from the spinal cord to the other parts of the body are
called lower motor neurons (LMNs). These spinal nerves exit and enter at
each vertebral level and communicate with specific areas of the body.
The sensory portions of the LMN's carry messages about sensation from
the skin and other body parts and organs to the brain. The motor
portions of the LMN's send messages from the brain to the various body
parts to initiate actions such as muscle movement.
The spinal cord is the major bundle of nerves that carry nerve impulses
to and from the brain to the rest of the body. The brain and the spinal
cord constitute the Central Nervous System. Motor and sensory nerves
outside the central nervous system constitute the Peripheral Nervous
System, and another diffuse system of nerves that control involuntary
functions such as blood pressure and temperature regulation are the
Sympathetic and Parasympathetic Nervous Systems.
The spinal cord is surrounded by rings of
bone called vertebra. These bones constitute the spinal column (back
bones). In general, the higher in the spinal column the injury occurs, the more dysfunction a person will experience. The
vertebra are named according to their location. The eight vertebra in
the neck are called the Cervical Vertebra. The top vertebra is called
C-1, the next is C-2, etc. Cervical SCI's usually cause loss of function
in the arms and legs, resulting in quadriplegia. The twelve vertebra in
the chest are called the Thoracic Vertebra. The first thoracic
vertebra, T-1, is the vertebra where the top rib attaches.
Injuries in the thoracic region usually affect the chest and the legs
and result in paraplegia. The vertebra in the lower back between the
thoracic vertebra, where the ribs attach, and the pelvis (hip bone), are
the Lumbar Vertebra. The sacral vertebra run from the Pelvis to the end
of the spinal column. Injuries to the five Lumbar vertebra (L-1 thru
L-5) and similarly to the five Sacral Vertebra (S-1 thru S-5)
generally result in some loss of functioning in the hips and legs.
are the effects of SCI?
The effects of SCI depend on the type of injury and the level of
the injury. SCI can be divided into two types of injury - complete and
incomplete. A complete injury means that there is no function below the
level of the injury; no sensation and no voluntary movement. Both sides
of the body are equally affected. An incomplete injury means that there
is some functioning below the primary level of the injury. A person with
an incomplete injury may be able to move one limb more than another, may
be able to feel parts of the body that cannot be moved, or may have more
functioning on one side of the body than the other. With the advances in
acute treatment of SCI, incomplete injuries are becoming more common.
The level of injury is very helpful in predicting what parts of the body
might be affected by paralysis and loss of function. Remember that in
incomplete injuries there will be some variation in these prognoses.
Cervical (neck) injuries usually result in four limb paralysis.
This is referred to as Quadriplegia.
Injuries above the C-4 level may require a ventilator for the person to
breathe. This is because the diaphragm is controlled by spinal
nerves exiting at the upper level of the neck. The well documented
horse riding accident of Christopher Reeve (Superman) resulted in a
'complete' spinal cord injury above C3 and he now has to use a
mechanical ventilator via a hole in his throat to breathe.
C-5 injuries often result in shoulder and biceps control, but no control
at the wrist or hand. C-6 injuries generally yield wrist control, but no
hand function. Individuals with C-7 and T-1 injuries can straighten
their arms but still may have dexterity problems with the hand and
Injuries at the thoracic level and below result in paraplegia, with the
hands not affected. At T-1 to T-8 there is most often control of the
hands, but poor trunk control as the result of lack of abdominal muscle
control. Lower T-injuries (T-9 to T-12) allow good truck control and
good abdominal muscle control. Sitting balance is very good. Lumbar and
Sacral injuries yield decreasing control of the hip flexors and legs.
Besides a loss of sensation or motor functioning, people with SCI also
experience other changes. For example, they may experience dysfunction
of the bowel and bladder,. Sexual functioning is frequently
impaired or lost with SCI. Men may have their fertility
affected, while a women's fertility is generally not affected. Other effects of SCI may include low blood pressure, inability to
regulate blood pressure effectively, reduced control of body temperature
, inability to sweat below the level of injury, and chronic pain.
is not what happens to you that determines your fate but what you do about it.
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