{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T05:34:37Z","timestamp":1793424877004,"version":"4.5.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Spinal cord injury (SCI) is a globally prevalent neurological condition, often resulting in motor, sensory, and autonomic dysfunctions that lead to permanent disability. However, outdated epidemiological data hinder the development and implementation of effective public health policies. This study aimed to examine and compare trends in the burden of spinal cord injury\u2014specifically incidence, prevalence, and years lived with disability (YLD)\u2014in China and worldwide from 1990 to 2021, and to project these trends over the next 15 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study analyzed the characteristics of the SCI burden in China and globally, examining changes in incidence, prevalence, and years lived with disability (YLD) using open data from the Global Burden of Disease database covering 1990 to 2021. Additionally, Joinpoint and age-period-cohort (APC) analyses were conducted to provide insights into the epidemiological characteristics of the SCI burden. The autoregressive integrated moving average (ARIMA) model was then applied to project SCI trends for the next 15 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 2021, the prevalence and incidence of SCI in China reached 2,766,277 and 99,363 cases, respectively, marking increases of 63.27 and 43.27% since 1990. From 1990 to 2021, the age-standardized prevalence rate (ASPR) of SCI decreased significantly, with an estimated annual percentage change (EAPC) of \u22120.34 (95% CI: \u22120.60 to-0.07). At the gender level, SCI prevalence and incidence were higher in men than in women. Joinpoint analysis revealed a significant decrease in the APC of the age-standardized incidence rate (ASIR) from 1990 to 2011 (APC\u202f=\u202f\u22120.98, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05), followed by a notable increase from 2011 to 2021 (APC\u202f=\u202f2.05, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). For ASPR, a significant decrease occurred from 2001 to 2005 (APC\u202f=\u202f\u22124.80, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05), while subsequent periods showed an increasing trend, particularly between 2010 and 2018 (APC\u202f=\u202f1.43, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05) and 2018\u20132021 (APC\u202f=\u202f2.84, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). In terms of age-standardized YLD rates (ASYR), China experienced an overall downward trend from 1990 to 2010 (APC\u202f=\u202f\u22120.56 for 1990\u20132001; \u22125.97 for 2001\u20132005; \u22121.01 for 2005\u20132010, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05), followed by a slight upward trend post-2010, with fluctuations from 2010 and 2018 (APC\u202f=\u202f0.88) and 2018\u20132021 (APC\u202f=\u202f2.49, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). Age-period-cohort analysis showed that the risk of SCI incidence increased with age in China, though both period and cohort effects demonstrated a significant downward trend. Projections indicate that by 2036, the ASIR and ASPR for SCI in China will reach 6 and 146 cases per 100,000 people, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The number and burden of SCI in China and globally have increased in the past. Among them, men and older people are more likely to develop SCI than women and younger people. Although the ASPR and ASIR for SCI are predicted to show a downward trend over the next 15\u202fyears, policy makers should continue to consider interventions to minimize the risk.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2024.1517871","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T07:43:24Z","timestamp":1736235804000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":23,"title":["Analysis and comparison of the trends in burden of spinal cord injury in China and worldwide from 1990 to 2021: an analysis of the global burden of disease study 2021"],"prefix":"10.3389","volume":"12","author":[{"given":"Hao","family":"Qin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhang","family":"Diao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyu","family":"Hao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhitan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minghao","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojun","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1517","DOI":"10.1007\/s00345-018-2301-z","article-title":"Epidemiology and pathophysiology of neurogenic bladder after spinal cord injury","volume":"36","author":"Hamid","year":"2018","journal-title":"World J Urol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1159\/000346419","article-title":"Therapeutic drug approach to stimulate clinical recovery after brain injury","volume":"32","author":"Krieger","year":"2013","journal-title":"Front Neurol Neurosci"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"E13","DOI":"10.3171\/FOC.2008.25.11.E13","article-title":"Cardiovascular complications after acute spinal cord injury: pathophysiology, diagnosis, and management","volume":"25","author":"Furlan","year":"2008","journal-title":"Neurosurg Focus"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1002\/pmrj.12218","article-title":"Spasticity and pain after spinal cord injury: impact on daily life and the influence of psychological factors","volume":"12","author":"Tibbett","year":"2020","journal-title":"PM R"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1038\/sc.2012.158","article-title":"The global map for traumatic spinal cord injury epidemiology: update 2011, global incidence rate","volume":"52","author":"Lee","year":"2014","journal-title":"Spinal Cord"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"309","DOI":"10.2147\/CLEP.S68889","article-title":"Global prevalence and incidence of traumatic spinal cord injury","volume":"6","author":"Singh","year":"2014","journal-title":"Clin Epidemiol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"S2","DOI":"10.1097\/00007632-200112151-00002","article-title":"Epidemiology, demographics, and pathophysiology of acute spinal cord injury","volume":"26","author":"Sekhon","year":"2001","journal-title":"Spine"},{"key":"ref8","unstructured":"2021"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","article-title":"Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the global burden of disease study 2021","volume":"403","year":"2024","journal-title":"Lancet"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2100","DOI":"10.1016\/S0140-6736(24)00367-2","article-title":"Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the global burden of disease study 2021","volume":"403","year":"2024","journal-title":"Lancet"},{"key":"ref11","unstructured":""},{"key":"ref12","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/j.jhep.2021.05.022","article-title":"Burden of non-alcoholic fatty liver disease in Asia, the Middle East and North Africa: data from global burden of disease 2009-2019","volume":"75","author":"Golabi","year":"2021","journal-title":"J Hepatol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/s13045-020-00915-0","article-title":"Epidemiological trends of tracheal, bronchus, and lung cancer at the global, regional, and national levels: a population-based study","volume":"13","author":"Deng","year":"2020","journal-title":"J Hematol Oncol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1002\/(sici)1097-0258(20000215)19:3<335::aid-sim336>3.0.co;2-z","article-title":"Permutation tests for joinpoint regression with applications to cancer rates [published correction appears in stat med 2001 Feb 28;20(4):655]","volume":"19","author":"Kim","year":"2000","journal-title":"Stat Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1002\/cac2.12197","article-title":"Cancer incidence, mortality, and burden in China: a time-trend analysis and comparison with the United States and United Kingdom based on the global epidemiological data released in 2020","volume":"41","author":"Qiu","year":"2021","journal-title":"Cancer Commu"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1945","DOI":"10.1007\/s13524-013-0243-z","article-title":"Assessing validity and application scope of the intrinsic estimator approach to the age-period-cohort problem","volume":"50","author":"Luo","year":"2013","journal-title":"Demography"},{"key":"ref17","first-page":"e00382","article-title":"Suicide mortality trends in four provinces of Iran with the highest mortality, from 2006-2016","volume":"17","author":"Nazari Kangavari","year":"2017","journal-title":"J Res Health Sci"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"803","DOI":"10.3233\/JAD-210225","article-title":"The burden of Alzheimer\u2019s disease mortality in the United States, 1999-2018","volume":"82","author":"Zhao","year":"2021","journal-title":"J Alzheimers Dis"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1834","DOI":"10.1089\/neu.2022.0450","article-title":"Importance of prospective registries and clinical research networks in the evolution of spinal cord injury care","volume":"40","author":"Kelly-Hedrik","year":"2023","journal-title":"J Neurotrauma"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1001\/jamaneurol.2020.4152","article-title":"Burden of neurological disorders across the US from 1990-2017: A global burden of disease study","volume":"78","author":"Feigin","year":"2021","journal-title":"JAMA Neurol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/s12028-010-9359-9","article-title":"Risk factors for organ dysfunction and failure in patients with acute traumatic cervical spinal cord injury","volume":"13","author":"Stein","year":"2010","journal-title":"Neurocrit Care"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1097\/BRS.0000000000003718","article-title":"Sports-related cervical spine fracture and spinal cord injury: A review of Nationwide Pediatric trends","volume":"46","author":"Alas","year":"2021","journal-title":"Spine"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1007\/s00068-018-0992-x","article-title":"Management of cervical spine trauma in children","volume":"45","author":"Copley","year":"2019","journal-title":"Eur J Trauma Emerg Surg"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1740","DOI":"10.1089\/neu.2020.6985","article-title":"Epidemiology and impact of spinal cord injury in the elderly: results of a fifteen-year population-based cohort study","volume":"37","author":"Wilson","year":"2020","journal-title":"J Neurotrauma"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1159\/000371519","article-title":"Contemporary trends in the epidemiology of traumatic spinal cord injury: changes in age and etiology","volume":"44","author":"Bellucci","year":"2015","journal-title":"Neuroepidemiology"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e39264","DOI":"10.1371\/journal.pone.0039264","article-title":"Age, sex, and socio-economic status affect the incidence of pediatric spinal cord injury: an eleven-year national cohort study","volume":"7","author":"Chien","year":"2012","journal-title":"PLoS One"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1016\/S1047-9651(18)30086-X","article-title":"Osteoporosis in women with spinal cord injuries","volume":"12","author":"Ott","year":"2001","journal-title":"Phys Med Rehabil Clin N Am"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"48","DOI":"10.2165\/00007256-199723010-00005","article-title":"Body composition of spinal cord injured adults","volume":"23","author":"Kocina","year":"1997","journal-title":"Sports Med"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"i96","DOI":"10.1136\/injuryprev-2019-043494","article-title":"Global injury morbidity and mortality from 1990 to 2017: results from the global burden of disease study 2017","volume":"26","author":"James","year":"2020","journal-title":"Inj Prev"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"S193","DOI":"10.1038\/nature16035","article-title":"Global neurotrauma research challenges and opportunities","volume":"527","author":"Rubiano","year":"2015","journal-title":"Nature"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1517871\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T07:43:27Z","timestamp":1736235807000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1517871\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,7]]},"references-count":30,"alternative-id":["10.3389\/fpubh.2024.1517871"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2024.1517871","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,7]]},"article-number":"1517871"}}