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Online ISSN 1973-9095
SPINAL CORD INJURIES
DeVivo M. J.
National Spinal Cord Injury Statistical Center, University of Alabama at Birmingham, Alabama, USA
Since 1983, the National Institute on Disability and Rehabilitation Research has been the agency of the federal government responsible for the designation as model spinal cord injury care systems, based on open competitions held every five years. Currently there are 18 model systems. The goal of the database has changed over time, but now includes documenting the long-term course of spinal cord injury and factors that affect that course, documenting patient demographics, causes of injury, treatment outcomes over time, rehabilitation treatment outcomes, and identifying potential persons for enrollment in appropriate study protocols. At present, the Spinal Cord Injury Statistical Center (NSCISC) database contains not only information on hospitalized patients but also follow-up data. Following a series of changes, there are now 126 variables in the database. The NSCISC makes use of every possible means of disseminating information to interested parties, including an internet web site (www.spinalcord.uab.edu) that contains all the necessary information about the NSCISC. The incidence of traumatic spinal cord injury in the United States is about 40 cases per million. According to the NSCISC, 53.3% of injuries occur among persons between the ages of 16-30, and 81.7% occur among males. The leading causes of spinal cord injury are motor vehicle crashes (38.6%), followed by falls (23.2%), and acts of violence (22.5%). In the United States, slightly greater than one half of spinal cord injuries occur in the cervical region of the spine and about half are neurologically complete. Current lengths of stay for acute care and rehabilitation are 25 days and 68 days, respectively, for persons with complete tetraplegia, and 10-12 days and 35-37 days, respectively, for less severe spinal cord injuries. Although life expectancies continue to improve, postinjury employment rates remain disappointing.