Shifting trends in the epidemiology of Cervical Spine Injuries: An Analysis of 11,822 patients from the National Electronic Injury Surveillance System (NEISS) over two decades.

Abstract

Cervical spine injuries (CSIs) are heterogeneous in nature and often lead to long-term disability and morbidity. However, there are few recent and comprehensive epidemiological studies on CSI. The objective of this study was to characterize recent trends in CSI patient demographics, incidence, etiology, and injury level. The National Electronic Injury Surveillance System (NEISS) was used to extract data on CSIs from 2002-2022. Weighted national estimates of CSI incidence were computed using yearly population estimates interpolated from United States census data. Data analysis involved extracting additional information from patient narratives to categorize injury etiology (i.e. fall), and to identify CSI level. K-means clustering was performed on cervical levels to define upper vs lower cervical injuries. Appropriate summary statistics including mean with 95% confidence intervals, and frequency were reported for age, sex, race, ethnicity, etiology, and disposition. Age between groups was compared using an independent weighted Z- test. All categorical variables were compared using Pearson chi-square with Bonferroni correction for multiple comparison. Ordinary least squares linear regression was used to quantify the rate of change of various metrics with time. A total of 11,822 patient records met the study criteria. The mean age of patients was 62.4 ± 22.7 years, 52.4% of whom were male and 61.4% of whom were white, 7.4% were black, 27.8% were not specified, the remaining comprised a variety of ethnicities. The most common mechanism of CSI was a fall (67.3%). There was a significant increase in the incidence of cervical injuries between 2003-2022 (p<0.001). Unbiased K means clustering defined upper cervical injuries as C1-C3 and lower cervical injuries as C4-C7. The mean age of patients with upper CSIs was 72.3 ± 19.6, significantly greater than the age of those with lower CSIs (57.1 ± 23.1, p<0.001). Compared with lower CSI, white patients were more likely to have an upper CSI (67.4% vs. 73.7%; p<0.001). While Black/African American (7.5% vs. 3.8%) and Hispanic (2.5% vs 1.0%) patients were more likely to have a lower CSI (p<0.001). Our study identified a significant increase in the incidence of CSIs over time which was associated with increasing patient age. Our study detected a pragmatic demarcation of classifying upper injuries as C1-C3 and lower cervical injuries as C4-C7. Upper injuries were seen more often in older, white females who were treated and admitted, and lower injuries were seen more often in young, black male patients who were released without admission.

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10.1089/neu.2024.0194

Publication Info

Futch, Brittany Grace, Andreas Seas, Favour Ononogbu-Uche, Shahenda Khedr, Judah Kreinbrook, Christopher I Shaffrey, Theresa Williamson, James David Guest, et al. (2024). Shifting trends in the epidemiology of Cervical Spine Injuries: An Analysis of 11,822 patients from the National Electronic Injury Surveillance System (NEISS) over two decades. Journal of neurotrauma. 10.1089/neu.2024.0194 Retrieved from https://hdl.handle.net/10161/31343.

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Abd-El-Barr

Muhammad Abd-El-Barr

Professor of Neurosurgery

As a Neurosurgeon with fellowship training in Spine Surgery, I have dedicated my professional life to treating patients with spine disorders. These include spinal stenosis, spondylolisthesis, scoliosis, herniated discs and spine tumors. I incorporate minimally-invasive spine (MIS) techniques whenever appropriate to minimize pain and length of stay, yet not compromise on achieving the goals of surgery, which is ultimately to get you back to the quality of life you once enjoyed. I was drawn to medicine and neurosurgery for the unique ability to incorporate the latest in technology and neuroscience to making patients better. I will treat you and your loved ones with the same kind of care I would want my loved ones to be treated with. In addition to my clinical practice, I will be working with Duke Bioengineers and Neurobiologists on important basic and translational questions surrounding spinal cord injuries (SCI), which we hope to bring to clinical relevance.


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