{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:30:44Z","timestamp":1792794644257,"version":"4.5.0"},"reference-count":45,"publisher":"SAGE Publications","issue":"17-18","license":[{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:p>\n                    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 was used to extract data on CSIs from 2002 to 2022. Weighted national estimates of CSI incidence were computed using yearly population estimates interpolated from U.S. census data. Data analysis involved extracting additional information from patient narratives to categorize injury etiology (i.e., fall) and identify CSI level. K-means clustering was performed on cervical levels to define upper versus 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\n                    <jats:italic toggle=\"yes\">Z<\/jats:italic>\n                    -test. All categorical variables were compared using Pearson chi-squared tests with Bonferroni correction for multiple comparisons. 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 \u00b1 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, and 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 and 2022 (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001). Unbiased K-means clustering defined upper cervical injuries as C1\u2013C3 and lower cervical injuries as C4\u2013C7. The mean age of patients with upper CSIs was 72.3 \u00b1 19.6, significantly greater than the age of those with lower CSIs (57.1 \u00b1 23.1,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001). Compared with lower CSI, White patients were more likely to have an upper CSI (67.4% vs. 73.7%;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 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 (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 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\u2013C3 and lower cervical injuries as C4\u2013C7. 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.\n                  <\/jats:p>","DOI":"10.1089\/neu.2024.0194","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T07:45:47Z","timestamp":1721720747000},"page":"2158-2167","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Shifting Trends in the Epidemiology of Cervical Spine Injuries: An Analysis of 11,822 Patients from the National Electronic Injury Surveillance System over Two Decades"],"prefix":"10.1177","volume":"41","author":[{"given":"Brittany Grace","family":"Futch","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0624-1254","authenticated-orcid":false,"given":"Andreas","family":"Seas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA."},{"name":"Department of Biomedical Engineering, Duke University Pratt School of Engineering, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Favour","family":"Ononogbu-Uche","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA."},{"name":"Downstate College of Medicine, State University of New York, Brooklyn, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahenda","family":"Khedr","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA."},{"name":"Department of Surgery, New York-Presbyterian\/Queens, Flushing, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judah","family":"Kreinbrook","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Williamson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James David","family":"Guest","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Miller School of Medicine, University of Miami, Miami, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5722-6364","authenticated-orcid":false,"given":"Michael G.","family":"Fehlings","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Toronto, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad M.","family":"Abd-El-Barr","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norah A.","family":"Foster","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Miami Valley Hospital, Centerville, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9,17]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181ae583b"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.6250"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30444-7"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-022-01578-2"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2022.107414"},{"issue":"2","key":"e_1_3_5_7_2","first-page":"60","article-title":"[Intraosseous hypertension in arthrosis of the knee joint]","author":"Kutepov AG","year":"1975","unstructured":"Kutepov AG. 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