• Mubarak Algahtany, Steven McFaull, Ling Chen, Shudong Zhang, Olli Saarela, Feras Alqahtani, and Michael D Cusimano.
• Division of Neurosurgery, Department of Surgery, King Khalid University, Abha, Saudi Arabia; College of Medicine, King Khalid University, Abha, Saudi Arabia; Division of Neurosurgery, Department of Surgery, St. Michael's Hospital Injury Prevention Research Office, Li KaShing Knowledge Institute, Keenan Research Centre, Toronto, Canada. Electronic address: mbalgahtany@kku.edu.sa.
• World Neurosurg. 2021 May 1; 149: e116-e127.

ObjectiveNo previous large population-based studies of traumatic spinal injury (TSI) rates, trends, and patterns exist. We aimed to fill this knowledge gap on TSI epidemiology using a population-based study of 13 million people.MethodsThis is a descriptive cross-sectional cohort study that analyzes a national, mandatory reporting database for all emergency departments and ambulatory care centers in Ontario over 15 years. Demographics of TSI, trends in the TSI rate, etiology, transfer, disposition, comorbidities, and associated traumatic brain injury or spinal cord injury were analyzed.ResultsThere were 167,357 TSI-related emergency department visits resulting in 70,684 hospitalizations and 376 deaths. The overall rate of TSI significantly increased from 66.94 to 118.61 per 100,000. Female patients had greater rates of TSI. Older patients had greater rates of TSI, especially related to falls. Fall was found to be the commonest mechanism of TSI, whereas motor vehicle collisions scaled down to the third commonest mechanism of TSI. Sport-related TSI had the greatest percentage of increase in the rate over all mechanisms (221%, P < 0.001). TSI with associated traumatic brain injury comprised 6% of the cohort but had the greatest percentage increase (91%) in the rate compared to all other TSI forms.ConclusionsThe rate of TSI continues to rise in Ontario as the population ages. The rise is primarily attributed to a shift in the epidemiology and etiology of TSI from a younger male population toward an older female population, with falls as the primary injury mechanism. Establishing preventive measures to address this shift is essential.Copyright © 2021 Elsevier Inc. All rights reserved.

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