Clinical Medicine Insights: Trauma and Intensive Medicine

Introduction: Cervical spinal cord injury (CSCI) is a significant medical and socioeconomic problem. In Victoria, Australia, there has been limited research into the incidence of CSCI. The Austin Hospital’s Victorian Spinal Cord Injury Service (VSCIS) is a tertiary referral hospital that accepts referrals for surgical management and ongoing neurological rehabilitation for south eastern Australia. The aim of this study was to characterise the epidemiology of CSCI managed operatively at the VSCIS over the last decade, in order to help fashion public health campaigns.

Methods: This was a retrospective review of medical records from January 2000 to December 2009 of all patients who underwent surgical management of acute CSCI in the VSCIS catchment region. Patients treated non-operatively were excluded. Outcome measures included: demographics, mechanism of injury and associated factors (like alcohol) and patient neurological status.

Results: Men were much more likely to have CSCI than women, with a 4:1 ratio, and the highest incidence of CSCI for men was in their 20s (39%). The most common cause of CSCI was transport related (52%), followed by falls (23%) and water-related incidents (16%). Falls were more prevalent among those .50 years. Alcohol was associated in 22% of all CSCIs, including 42% of water-related injuries.

Discussion: Our retrospective epidemiological study identified at-risk groups presenting to our spinal injury service. Young males in their 20s were associated with an increased risk of transport-related accidents, water-related incidents in the summer months and accidents associated with alcohol. Another high risk group were men .50 years who suffer falls, both from standing and from greater heights. Public awareness campaigns should target these groups to lower incidence of CSCI.