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Online ISSN 1973-9095
Caldana L., Lucca L.
Spinal Cord Unit, Department of Rehabilitation, ULSS 6, Vicenza, Italy
BACKGROUND: This paper is the result of a research project designed to record the cases of spinal cord injury (SCI) and nontraumatic spinal cord disease (SCD) diagnosed and treated for the first time in Veneto in the years 1994 and 1995.
METHOD: We selected 28 ISTAT code numbers grouped according to the main diseases and spinal cord injuries. We examined 8.437 clinical diaries from the hospitals located in the Provinces of Padova, Treviso, Verona, Vicenza and also from hospitals in Belluno, Negrar, and Venezia-Lido.
RESULTS: The annual incidence of traumatic SCI was 14.34 cases per million people. A total of 127 traumatic lesions were recorded over the two-year period. There was a fairly even distribution between 1994 (60 cases) and 1995 (67 cases), but not across the provinces in Veneto. The highest annual incidences were 19.2 cases/million inhabitants in Treviso and 18.3 cases/million inhabitants in Rovigo. The lowest annual incidence was 10.5 cases/million inhabitants in Vicenza. The distribution according to gender was as follows: 106 males, mean age 39.8 years, and 21 females, mean age 36 years; traumatic SCI subjects over 70 years: 6 males, 12 females; traumatic SCI subjects below 20 years: 2 males, 4 females. Grouping according to age revealed that people in their 30s showed the highest incidence (36 cases, 28.3%) followed at a distance by people in their 50s, and 60s, and by people in their 20s, 40s and 70s all at the same level. In 1994, 16.5% of the total population of Veneto were in their 30s. The nontraumatic SCD included: primary tumours (38 cases), secondary tumours and malignant hemopathies, (115), vascular myelopathies (33), myelopathy due to herniated disk (11), various or unclassified causes (32), stenosis of the vertebral canal (149), Multiple Sclerosis (51), spina bifida and the Arnold-Chiari syndrome (21). Among these causes, 55 induced complete spinal lesions, and 395 incomplete spinal lesions. We would estimate that at least a tenth of the 395 patients with incomplete lesions (i.e. 40 cases in the two-year period) needed to be hospitalized. This figure could raise the annual cases per million inhabitants from 6.1 to 10.7 and increase the percentage of spinal cord lesions of nontraumatic causes from 30% to 40%.
CONCLUSIONS: The most important data from this epidemiological study of the new cases of traumatic and nontraumatic SCI in Veneto in the period 1994 through 1995 was that the overall incidence of lesions may be estimated at around 25 cases/million inhabitants/year.