Department of Physical Medicine and Rehabilitation, Inje University Ilsan Paik Hospital, Goyang, Korea
Corresponding author: Jeehyun Yoo Department of Physical Medicine and Rehabilitation, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Goyang 10380, Korea. Tel: +82-31-910-7440, Fax: +82-31-910-7446, E-mail: jhyoo@paik.ac.kr
• Received: July 21, 2020 • Revised: August 19, 2020 • Accepted: August 24, 2020
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
To investigate the epidemiologic and demographic characteristics of patients with spinal cord injury (SCI) who were admitted to a department of rehabilitation of a university hospital.
Methods
This was a descriptive cross-sectional study. Medical records including sex, age at injury, type of disability, traumatic or non-traumatic etiology and presence of ossification of posterior longitudinal ligament (OPLL) of patients with SCI who were admitted to the department of rehabilitation between 2012 and 2018 were reviewed.
Results
Of the 221 cases of SCI, 161 were traumatic and 60 were non-traumatic. The mean age at injury was 52.8 years. People aged 40–49 years showed highest proportion among overall SCI patients (19.0%). The proportion of male patients was higher in traumatic SCI at 4.96:1 than in non-traumatic SCI at 1.30:1. The most common cause of traumatic SCI was falling off (37.3%), followed by motor vehicle crash (35.4%) and tripping over (19.3%). Meanwhile, the most common cause of non-traumatic SCI was neoplasm (35.0%). Tripping over was the leading cause of traumatic SCI in patients aged ≥60 years (42.6%). A high proportion of traumatic SCI patients were found to have underlying OPLL (26.1%), particularly those who were injured by tripping over (64.5%).
Conclusion
The mean age of SCI patients was higher than that of previous studies. Falls was the single most common cause of traumatic SCI, and tripping over was the most common cause of injury in the elderly patients. OPLL was prevalent in patients who were injured from tripping over.
Spinal cord injury (SCI) is one of the major insults to the central nervous system that results in persisting physical and psychological sequelae, thereby incurring tremendous socioeconomic costs related to health care treatment, rehabilitation, and loss of productivity [1-4]. Therefore, extensive efforts for predicting and preventing SCI should be made to improve national health and welfare. Educational programs that are designed based on epidemiologic studies have shown to be successful in reducing the incidence of traumatic SCI [5-8]. In the United States, epidemiologic changes in age, sex, and completeness of injury of SCI are continuously being monitored by the National Spinal Cord Injury Statistical Center (NSCISC), and a gradual increase in the prevalence of the people with old age, female sex, and incomplete injury has been reported [9-12]. In Asia, only Japan and Taiwan are counting and registering traumatic SCI people in the perspective of epidemiology. Other Asian countries, including Korea, do not take the same approach [13]. Particularly, in Korea, people with SCI are being counted as having “physical disability” and clustered together with other disabilities; thus, the exact incidence of SCI can only be assumed indirectly [14]. Some of the most recent studies in Korea that analysed national demographic data specific to SCI were those by Park et al. [15], Shin et al. [16], and by the National Rehabilitation Center [17]. Park et al. [15] reported traffic accidents as the most common cause of traumatic SCI, accounting for 57.6%, and falls as the second most common cause, accounting for 26.4% in 1999. However, the study by the National Rehabilitation Center in 2014 [17] showed that the percentage of SCI caused by traffic accidents had decreased from 64% in 1994–2000 to 45% in 2008–2014. The proportion of falls had risen from 23% to 43% during the same time intervals, implying a change in trends regarding the etiology of traumatic SCI.
There are many explanations and hypotheses in interpreting the changes in SCI epidemiology worldwide, and understanding each country’s demographic characteristics and cultural specificity in connection with etiology is important in interpretation. For example, falls account for 63.0% of SCI in Bangladesh, which is a developing Asian country with a low-income economy and a small urban population. Those injuries mostly occur among those aged between 10 years and 40 years and are mainly attributed to falling from trees or carrying heavy objects on the head. Meanwhile, in eastern Canada, which is a developed country with a high-income economy and a large urban population, the mean age at the time of SCI was 55.4 years, and falls accounted for only 19.1% of SCI etiology. However, falls were the leading cause of SCI in the elderly (i.e., age ≥60 years), accounting for 47% [18].
One of the most remarkable demographic characteristics of Korea is rapid aging of population, and this is occurring in many developed nations including those in Europe [19,20]. Data from Statistics Korea show that in 2018, 14.3% of the population were aged ≥65 years, and this proportion is projected to increase to 35.9% by 2050 and to 41.0% by 2060 [21,22].
On the other hand, one of other characteristics of Korean population is high prevalence of ossification of posterior longitudinal ligament (OPLL), which is thought to be related to incurring cervical SCI with minor trauma [23-25]. OPLL is pathological calcification of posterior longitudinal ligament, which occurs more frequently in Asian population than other races [26] and most commonly at the cervical spine [27]. Depending on the size, OPLL can results in the spinal canal narrowing and more importantly, compression of the spinal cord and trauma-induced sudden onset myelopathy. The mainstay treatment of OPLL is surgical decompression, including corpectomy, laminectomy, and combined fusion [27].
This study aimed to investigate the effect of demographic changes on SCI epidemiology in Korea with cross-sectional data of single university hospital. We hypothesized that an aging population might present more injuries caused by minor traumas such as low falls including slip-down and tripping over even in level ground or in the stairs, as in other developed countries. We also hypothesized that increase in mean age of SCI people might be related to more comorbidities of degenerative diseases such as OPLL, which contributes to SCI. To determine the impact of population aging on changes in SCI etiology, we separated falls into two categories, namely, high-energy trauma and low-energy trauma, by separately calculating the high falls (falling off) and low falls (tripping over).
MATERIALS AND METHODS
Study design and subjects
This was a descriptive cross-sectional study of individuals with SCI from traumatic or non-traumatic causes who were hospitalized for comprehensive rehabilitation to a dedicated hospital between January 2012 and June 2018. Data on demographic, injury, and medical characteristics were obtained from hospital admission records. This study was approved by Inje University Ilsan Paik Hospital Institutional Review Board (No. 2020-03-027). SCI was defined as the event of a traumatic or non-traumatic lesion of neural elements in the spinal canal that resulted in temporary or permanent sensory and/or motor deficit [28].
Descriptive analyses of SCI are suggested with stratification by key demographic characteristics and SCI-specific characteristics (e.g., sex, age at injury, American Spinal Injury Association Impairment Scale [AIS] score at admission and discharge, SCI type, and etiology) according to the International Spinal Cord Society guidelines, where possible [29].
Categorization of falls
Falls were categorized into low (<1 m) or high falls (≥1 m) based on available information on cause of injury in the medical records [28]. A 1-m cutoff for classifying the level of falls was chosen to facilitate comparison with previous reports in the literature and with reference to the World Health Organization’s (WHO’s) International Perspectives on SCI report. The WHO report categorized falls into 4 different patterns: (1) falls on the same level, (2) falls from heights of <1 m, (3) falls from heights of ≥1 m, and (4) being struck by a falling object [30]. We classified categories 1 and 2 as low fall (tripping over), and 3 as high fall (falling off). There was no case for category 4 in this study.
Statistical analysis
Descriptive statistics (mean, standard deviation, frequency, ratio, and percentage) were used to describe the clinicodemographic characteristics of the study participants across injury etiologies. Student t-test and chi-square test, as appropriate, were used to assess the differences between the etiology groups at a statistical significance level of 0.05. All analyses were performed using the IBM Statistical Package for the Social Sciences, software version 22.0 (IBM Corp., Armonk, NY, USA).
RESULTS
Epidemiology and demographics
In total, 221 cases of SCI were included in the study. Of these, 161 were traumatic and 60 were non-traumatic. In the traumatic SCI group, 134 (83.2%) were men and 34 (16.8%) were women; in the non-traumatic SCI group, 27 (56.7%) were men and 26 (43.3%) were women. The proportion of male patients was noticeably higher in the traumatic SCI group at 4.96:1 than in the non-traumatic SCI group at 1.30:1. The mean age of the overall cohort was 52.8±17.9 years, and that of the traumatic and the non-traumatic SCI groups were 49.8±18.0 and 60.7±15.2 years, respectively. The patient characteristics are shown in Table 1. The proportion of the 40–49 year age group was the highest among overall patients (19.0%), and majority (21.1%) of patients in the traumatic SCI group were also aged 40–49 years. Meanwhile, majority (26.7%) of patients in the non-traumatic SCI group were aged 70–79 years.
Etiology
With respect to etiology, falling off was the most common cause of traumatic SCI (n=60/161, 37.3%), followed by motor vehicle crashes (MVC) (n=57, 35.4%) (Table 2). Categorizing tripping over and falling off (n=31, 19.3%) together as falls, it becomes a more dominant cause of traumatic SCI, accounting for 56.5%. The age distribution according to the detailed trauma etiology is shown in Table 2. The most common cause of SCI varied in each age group. In the 10–19, 20–29, and 50–59 years age group, falling off was the most common cause of traumatic SCI, accounting for 54.5%, 63.6%, and 46.2%, respectively. Meanwhile, in those aged 60 years or older, tripping over was the leading cause of traumatic SCI, accounting for 37.0%, 40.9%, and 80.0% in the 60–69, 70–79, and 80–89 years age groups, respectively. The mean age of each traumatic etiology was also distinct from each other. Particularly, patients who were injured by tripping over showed a significantly higher mean age of 62.9±16.9 years compared to patients with other etiologies (p<0.001).
The mean age and AIS score and the detailed number of cases of non-traumatic etiology are shown in Table 3. The most common cause of non-traumatic SCI was neoplasm, accounting for 35.0%. The mean age of each etiology was mostly over 60 years, except for infectious disease and other non-traumatic causes, which was at 59.1 and 56.6 years, respectively. There were only two patients who presented complete injury (AIS-A), while the other 58 patients were incompletely injured by non-traumatic causes.
Type of disability and severity of injury
The types of disabilities and severity of injury caused by SCI are detailed in Table 2. The majority (47.8%) of traumatic SCI patients presented incomplete tetraplegia, except patients who were injured by falling off. Most (74.2%) of the patients who were injured by tripping over presented incomplete tetraplegia. Non-traumatic causes of SCI most commonly resulted in incomplete paraplegia (58.3%) followed by incomplete tetraplegia (38.3%).
Prevalence of OPLL in traumatic SCI patients
Table 4 shows the number of patients with OPLL in the traumatic SCI group. In total, 42 patients (26.1%) were found to have underlying OPLL. The prevalence of OPLL in patients who were injured by tripping over was high at 64.5% (20/31 cases). Among the traumatic SCI patients with OPLL, the level of OPLL and neurological level of injury matched each other in 92.9% (39/42 cases).
DISCUSSION
This study investigated the epidemiologic and demographic characteristics of patients with SCI who were admitted to rehabilitation unit of a university hospital in South Korea. We found a significantly higher proportion of male patients than female patients. Specifically, 76.0% of the patients were men, with a male-to-female ratio of 3.17:1 (168:53). This result is similar to that of one of the latest Korean epidemiologic study by Shin et al. in 2013, which showed that 74.1% of patients with all-cause SCI were men, with a male-to-female ratio of 2.86:1 [16]. This sex imbalance was more profound in traumatic SCI patients, with a male-to-female ratio of 4.96:1 (134:27), which is consistent with or more significant than that in previous epidemiologic studies in Korea [14,16,17]. This tendency of dominance of male cases in traumatic SCI is also consistent with previous epidemiologic studies in other developed countries [28,31]. Meanwhile, non-traumatic SCI showed smaller difference in the sex ratio at 1.30:1 (34 males, 26 females) in our study, which is closely consistent (1.47:1) with recent study by Shin et al. [16].
With respect to the etiology of traumatic SCI, our study showed that falls, counting low and high falls together, was the single most common cause, accounting for 56.5% (n=91) of all traumatic causes, followed by MVCs at 35.4% (n=57). The dominance of falls as a cause of traumatic SCI in our study is consistent with the trend of recent studies on traumatic SCI epidemiology [9,28,31,32]. This trend of changes in etiology is relatively recent finding in Korea. From 1987–1996 to 2004–2008, the proportion of MVC and falls both increased from 57.6%, 26.4% to 60.3%, 33.9%, relatively [16]. However, comparing the etiology from 2004 to 2014, the proportion of MVC decreased from 64% to 45% and falls increased from 23% to 43% [17].
It is also assumed that the older mean age of the patients at the onset of trauma in our study might have contributed to this result. According to the population data from Statistics Korea, the proportion of people older than 60 increased from 14.4% to 21.6% between 2008 and 2018 [33] (Fig. 1). Comparing our study results with the previous study of Shin et al. [16], the proportion of people older than 60 among traumatic SCI patients increased from 20.0% to 33.5%, from 2004–2008 to 2012–2018. Changes in the mean age at overall SCI and proportion of the patients older than 60 are shown in Fig. 2. Shin et al. [16] reported that falls was the most common cause of injury in people older than 60 years, with falls accounting for 54.2% of all traumatic causes in this age group. In our study the proportion of falls was highest among all causes of traumatic SCI in the patients aged 60 years or older, accounting for 68.5%. Similar trend is observed in other developed countries. In the United States, falls are the leading cause of SCI among persons aged over 60 years accounting for 55.8% [12]; in Norway, falls accounted for 65% of all injuries in persons older than 60 years [9,31]. In the United States, the mean age at SCI onset tended to be consistent and then gradually increased. In the 1970s, the mean age was 28.7 years, but it increased to 37.6 years in 2000–2004 and to 43.1 years in 2015–2019 showing increasing ages in all causes of SCI [12]. In Korea, the mean age at SCI onset was 32.3 years in 1985 and increased to 43.6 years in 1999. In our study, the mean age at SCI was 52.8 years, and 39.82% of the overall SCI patients were aged 60 years or older.
Our study counted low fall and high fall separately to place them into low-energy trauma and high-energy categories. In total, 60 and 31cases of traumatic SCI were attributed to high fall and low fall, respectively. Among the 54 patients aged over 60 years, 14 patients were injured from high fall, accounting for 25.9% of all traumatic causes in this age group. Twenty-three patients in the same age group were injured by low fall, accounting for 42.6% of all traumatic causes in this age group. A similar tendency is also found in the United States. Compared with other age groups, the elderly had the highest frequency of low falls on the same level, from the stairs, and slipping and stumbling [32]. The incidence of fall-related traumatic SCIs appeared to be age dependent, particularly for low fall injuries. In traumatic SCIs, the proportion of SCI from falls increased with age; 14.4%, 38.7%, 55.8% in 0–45, 46–60, over 61 age groups, respectively [12].
In this study, we investigated the prevalence of OPLL in SCI patients, which is a common comorbidity for Asians. OPLL contributes to the occurrence of low-energy traumatic SCI, particularly, cervical cord injury when low fall accidents happen. Among the 31 patients with traumatic SCI who experienced low fall injuries, 20 (64.5%) had underlying OPLL. This proportion is much higher than the 0.6%–4.6% prevalence of incidental finding in the normal population in previous national studies [23,25,34]. In those studies, OPLL was prevalent in 16.9% of men aged over 65 years, which is higher than that in younger people, but still far lower than among the patients who experienced low falls in our study. This tendency of higher prevalence of OPLL in older patients supports our findings that show a correlation between higher mean age of traumatic SCI patients and incomplete cervical cord injury caused by low fall event.
Among non-traumatic etiologies, neoplasm was the single most common cause of SCI, accounting for 35.0%, followed by demyelinating disease and infectious disease as the second most common causes (16.7% each). Vascular disease accounted for 10% and degenerative disease followed at 8.3%. Other causes including herniated vertebral disc, spinal stenosis accounted for 13.3% of non-traumatic SCI.
With respect to disability types and severity of injury, the epidemiologic study by Shin et al. [16] in 2013 showed incomplete tetraplegia as the most common type, accounting for 36.9% of all SCI. According to annual reports of NSCISC [12] and as Jain et al. [35] suggest, the proportion of cervical spinal cord injury and incomplete injury has increased gradually in United States. In our study, 127 (54.3%) patients had tetraplegia, and only 27 (21.3%) among them presented complete injury. Gradual increase in the proportion of incomplete injury from 1987–1996 to 2012–2018 according to previous study and our study results is shown in Fig. 3 [16]. A notably low proportion of complete injury might be attributed to not only developments in prompt medical and surgical management after SCI, but also the increase in low-energy trauma injuries. In our study, the mean age of patients was higher than that in previous studies, and incomplete tetraplegia was the most common result after low-energy trauma. Among 31 patients who were injured by low fall, 27 (87.1%) had tetraplegia, and only 4 among them presented complete injury.
There are several limitations in this study. The data source for this study was limited to one university hospital and is not population based. Therefore, our study results might not be generalizable to the overall population of people with SCI in Korea. Also, we could only acquire information from the patients who were admitted or transferred to the rehabilitation medicine department of our hospital. Thus, we could not evaluate SCI patients who died or were discharged before transferring to our department. This might result in underestimation of the fatal SCI or less severe SCI. In addition, we could only check the patients’ AIS upon admission or when they were transferred to our department. Therefore, the timing of evaluation of severity and type of SCI varied, and this which could have influenced the severity of injury itself. Lastly, we did not analyse specific types of OPLL in the traumatic SCI patients. It would be meaningful to specify the type of OPLL in correlation with the SCI in further study. Despite these limitations, our study remains valuable because to our best knowledge, this is the latest study that reports the epidemiology and etiology of SCI in Korea.
In conclusion, this study demonstrates the cross-sectional analysis of the clinicodemographic characteristics of SCI patients in a university hospital in South Korea and showed its similarity with that of other developed, aging countries in Europe and North America. The epidemiology of SCI in Korea might be characterized by high mean age at time of injury and dominance of falls, especially low falls, as a cause of traumatic SCI.
CONFLICTS OF INTEREST
No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTION
Conceptualization: Kim HS, Lim KB, Yoo J. Methodology: Kim HS, Kim J, Yoo J. Formal analysis: Kim J, Kang J, Lee H, Lee SW. Project administration: Kim HS, Yoo J. Visualization: Lim KB, Kang J, Lee H. Writing – original draft: Kim HS, Yoo J. Writing – review and editing: Lim KB, Kim J. Approval of final manuscript: all authors.
Fig. 1.
Changes in proportion of elderly people among Korean population.
Fig. 2.
Changes in proportion of elderly patients and mean age at injury.
Fig. 3.
Changes in proportion of incomplete spinal cord injury.
Table 1.
Study characteristics by spinal cord injury etiology
2. Price C, Makintubee S, Herndon W, Istre GR. Epidemiology of traumatic spinal cord injury and acute hospitalization and rehabilitation charges for spinal cord injuries in Oklahoma, 1988-1990. Am J Epidemiol 1994;139:37-47.
4. Sohn S, Kim J, Chung CK, Lee NR, Sohn MJ, Kim SH. A nation-wide epidemiological study of newly diagnosed primary spine tumor in the adult Korean population, 2009-2011. J Korean Neurosurg Soc 2017;60:195-204.
7. Shults RA, Sleet DA, Elder RW, Ryan GW, Sehgal M. Association between state level drinking and driving countermeasures and self reported alcohol impaired driving. Inj Prev 2002;8:106-10.
11. Jackson AB, Dijkers M, Devivo MJ, Poczatek RB. A demographic profile of new traumatic spinal cord injuries: change and stability over 30 years. Arch Phys Med Rehabil 2004;85:1740-8.
19. Lee BB, Cripps RA, Fitzharris M, Wing PC. The global map for traumatic spinal cord injury epidemiology: update 2011, global incidence rate. Spinal Cord 2014;52:110-6.
22. He W, Goodkind D, Kowal P. An aging world 2015. Washington, DC: US Census Bureau; 2016.
23. Sohn S, Chung CK, Yun TJ, Sohn CH. Epidemiological survey of ossification of the posterior longitudinal ligament in an adult Korean population: three-dimensional computed tomographic observation of 3,240 cases. Calcif Tissue Int 2014;94:613-20.
24. Inamasu J, Guiot BH, Sachs DC. Ossification of the posterior longitudinal ligament: an update on its biology, epidemiology, and natural history. Neurosurgery 2006;58:1027-39.
25. Jin BH, Kim YS. Ossification of spinal ligaments. J Korean Neurosurg Soc 1991;20:875-84.
26. Fujimori T, Le H, Hu SS, Chin C, Pekmezci M, Schairer W, et al. Ossification of the posterior longitudinal ligament of the cervical spine in 3161 patients: a CT-based study. Spine (Phila Pa 1976) 2015;40:E394-403.
28. Chamberlain JD, Deriaz O, Hund-Georgiadis M, Meier S, Scheel-Sailer A, Schubert M, et al. Epidemiology and contemporary risk profile of traumatic spinal cord injury in Switzerland. Inj Epidemiol 2015;2:28.
29. DeVivo MJ, Biering-Sorensen F, New P, Chen Y; International Spinal Cord Injury Data Set. Standardization of data analysis and reporting of results from the International Spinal Cord Injury Core Data Set. Spinal Cord 2011;49:596-9.
30. Knutsdottir S, Thorisdottir H, Sigvaldason K, Jonsson H Jr, Bjornsson A, Ingvarsson P. Epidemiology of traumatic spinal cord injuries in Iceland from 1975 to 2009. Spinal Cord 2012;50:123-6.
31. Halvorsen A, Pettersen AL, Nilsen SM, Halle KK, Schaanning EE, Rekand T. Epidemiology of traumatic spinal cord injury in Norway in 2012-2016: a registry-based cross-sectional study. Spinal Cord 2019;57:331-8.
32. Chen Y, Tang Y, Allen V, DeVivo MJ. Fall-induced spinal cord injury: external causes and implications for prevention. J Spinal Cord Med 2016;39:24-31.
33. Ministry of the Interior and Safety. Statistics of residence registration population 2008-2018. Sejong, Korea: Ministry of the Interior and Safety; 2019.
34. Kim TJ, Bae KW, Uhm WS, Kim TH, Joo KB, Jun JB. Prevalence of ossification of the posterior longitudinal ligament of the cervical spine. Joint Bone Spine 2008;75:471-4.
Prevalence of opioid use in adults with spinal cord injury: A systematic review and meta-analysis Samantha J. Borg, Cate M. Cameron, Karen Luetsch, Adam Rolley, Timothy Geraghty, Steven McPhail, Victoria McCreanor The Journal of Spinal Cord Medicine.2025; 48(2): 170. CrossRef
Improving current understanding of cognitive impairment in patients with a spinal cord injury: A UK-based clinician survey Hamish Patel, Daniel Blackburn, Ram Hariharan, Krishnan Padmakumari Sivaraman Nair, Simon M. Bell The Journal of Spinal Cord Medicine.2025; 48(6): 1061. CrossRef
The potential role of RhoA/ROCK-inhibition on locomotor recovery after spinal cord injury: a systematic review of in-vivo studies Armin Khavandegar, Negar Sadat Ahmadi, Maryam Alsadat Mousavi, Zahra Ramezani, Elaheh Khodadoust, Mahgol Sadat Hasan Zadeh Tabatabaei, Zahra Hasanpour Segherlou, Arman Zeinaddini-Meymand, Fatemeh Nasehi, Maral Moafi, Kimia RayatSanati, Rasool Masoomi, Sor Spinal Cord.2025; 63(3): 95. CrossRef
Animal Models of Spinal Cord Injury Vladislav E. Sobolev, Yuriy I. Sysoev, Tatiana V. Vyunova, Pavel E. Musienko Biomedicines.2025; 13(6): 1427. CrossRef
Weather patterns forecast the severity of cervical spinal cord injuries Robert J. Quon, Josh Feler, Ziqi Wang, Owen P. Leary, Anarina Murillo, Jared S. Fridley Scientific Reports.2025;[Epub] CrossRef
Global, regional, and national burden of spinal cord lesion at neck level a systematic analysis of incidence, prevalence, YLDs with projections to 2046 Yi Zhang, Weilun Zhao, Xiaoming Peng, Fayun Yang, Shaohui Zong Frontiers in Public Health.2025;[Epub] CrossRef
Interplay of axon regeneration genes and immune infiltration in spinal cord injury Zimin Xiang, Dingxi Fang, Danping Gao, Qi Zhang, Yuxuan Zhang, Yuping Sun, Liyan Li, Xiaoqian Zhang, Jiaxin Li, Lingzhi Ding Journal of Translational Medicine.2025;[Epub] CrossRef
Improving current understanding of cognitive impairment in spinal cord injury: The patient perspective Hamish Patel, Liam Knox, Daniel Blackburn, Clare Bartlett, Lise Sproson, Krishnan Padmakumari Sivaraman Nair, Ram Hariharan, Simon M. Bell The Journal of Spinal Cord Medicine.2025; : 1. CrossRef
Research Progress of Early Tracheotomy in Patients with Cervical Spinal Cord Injury 娇 彭 Nursing Science.2024; 13(01): 42. CrossRef
Assessing Regional Weather’s Impact on Spinal Cord Injury Survivors, Caregivers, and General Public in Miami, Florida Danielle Hildegard Bass, Pardis Ghamasaee, Gregory E. Bigford, Mandeville Wakefield, Lunthita M. Duthely, Daniel Samano International Journal of Environmental Research and Public Health.2024; 21(4): 382. CrossRef
Pathophysiology of spinal cord injury and potential health benefits of omega-3 fatty acid Waliullah Shah, Ara Zeenat, Lafi Al-Otaibi Mohammed, Alam Khurshid, Shatakshi International Journal of Medicine and Medical Sciences.2024; 16(1): 15. CrossRef
The Changing Prevalence of Pressure Injury among Ontarians with SCI/D at Rehabilitation Admission: Opportunities for Improvement Beverley Catharine Craven, Emma A. Bateman, Heather Flett, Farnoosh Farahani, Dalton L. Wolfe, Sussan Askari, Maryam Omidvar, Mohammad Alavinia Healthcare.2024; 12(11): 1084. CrossRef
The burden and psychosocial impact on immediate caregivers of patients with spinal cord injury in a tertiary health facility, Edo State, Nigeria Timothy Aghoghko Ehwarieme, Uzezi Josiah, Auwuli Emina Journal of Integrative Nursing.2024; 6(2): 103. CrossRef
Ozone therapy vs. classical treatment in musculoskeletal disorders Maricela Dragomir, Claudiu Mereuță, Carmen Gheorghe Balneo and PRM Research Journal.2024; 15(Vol.15, no): 739. CrossRef
Impact of commonly administered drugs on the progression of spinal cord injury: a systematic review Lucie Bourguignon, Louis P. Lukas, Bethany R. Kondiles, Bobo Tong, Jaimie J. Lee, Tomás Gomes, Wolfram Tetzlaff, John L. K. Kramer, Matthias Walter, Catherine R. Jutzeler Communications Medicine.2024;[Epub] CrossRef
p53/HIF-1α regulates neuronal aging and autophagy in spinal cord ischemia/reperfusion injury Xingzhen Liu, Jia Wang, Kangping Shen, Wenjie Jin Mechanisms of Ageing and Development.2024; 222: 112000. CrossRef
The Role of Psychological Variables in Predicting Rehabilitation Outcomes After Spinal Cord Injury: An Artificial Neural Networks Study Marta Mascanzoni, Alessia Luciani, Federica Tamburella, Marco Iosa, Emanuela Lena, Sergio Di Fonzo, Valerio Pisani, Maria Carmela Di Lucente, Vincenzo Caretti, Lucia Sideli, Gaia Cuzzocrea, Giorgio Scivoletto Journal of Clinical Medicine.2024; 13(23): 7114. CrossRef
Trends in the Incidence and Etiology of Non-Traumatic Spinal Cord Injury in Korea: A Nationwide Population-Based Study From 2007 to 2020 Yoonjeong Choi, Ja-Ho Leigh, Jooeun Jeon, Goo Joo Lee, Hyung-Ik Shin, Moon Suk Bang Journal of Korean Medical Science.2023;[Epub] CrossRef
Incidence and prevalence of traumatic spinal cord injury in Canada using health administrative data Nancy P. Thorogood, Vanessa K. Noonan, Xiaozhi Chen, Nader Fallah, Suzanne Humphreys, Nicolas Dea, Brian K. Kwon, Marcel F. Dvorak Frontiers in Neurology.2023;[Epub] CrossRef
Epidemiology and Assessment of Traumatic Spinal Cord Injury With Concomitant Brain Injury: An Observational Study in a Regional Trauma Center Tae Woong Yang, Dong Ho Yoo, Sungchul Huh, Myung Hun Jang, Yong Beom Shin, Sang Hun Kim Annals of Rehabilitation Medicine.2023; 47(5): 385. CrossRef
The Correlation between Lumbosacral Transitional Anatomy and Pars Defect Gabriel S. Gonzales-Portillo, Mauricio J. Avila, Omar Rizvi, Travis M. Dumont Indian Spine Journal.2022; 5(2): 209. CrossRef
Impact of Mechanism of Injury on Long-term Neurological Outcomes of Cervical Sensorimotor Complete Acute Traumatic Spinal Cord Injury Alex B. Bak, Ali Moghaddamjou, Anahita Malvea, Michael G. Fehlings Neurospine.2022; 19(4): 1049. CrossRef
, Kil-Byung Lim, MD, PhD
