Global mapping for the epidemiology of paediatric spinal cord damage: towards a living data repository

Study design: Literature review. 

Objectives: Globally map key paediatric spinal cord damage epidemiological measures and provide a framework for an ongoing repository of data. 

Setting: Worldwide, initiative of ISCoS Prevention Committee. Methods: Literature search of Medline (1946–March 2017) and Embase (1974–March 2017). Relevant articles in any language regarding children with spinal cord damage included. Stratification of data quality into Green/Yellow /Red ‘zones’ facilitated comparison between countries. 

Results: A total of 862 abstracts were reviewed and data from 25 articles were included from 14 countries in 6 of the 21 Global Regions. Fourteen studies involved paediatric traumatic spinal cord injury (SCI) and seven were regarding non-traumatic spinal cord dysfunction (SCDys). An additional four articles provided both paediatric SCI and SCDys data. The median SCI incidence rates in Global Regions were: Asia, East 5.4/million population/year; Australasia 9.9/million population/year; Western Europe 3.3/million population/year and North America, High Income 13.2 million population/year. The median SCDys incidence rates in Global Regions were: Australasia 6.5/million population/year; Western Europe 6.2/million population/year and North America, High Income 2.1/million population/year. SCI was mostly due to land transport (46–74%), falls (12–35%) and sport/recreation (10–25%) and SCDys was mostly caused by tumours (30–63%) and inflammatory/autoimmune causes (28–35%). 

Conclusions: There is a scarcity of quality epidemiology studies of paediatric SCD regarding incidence, prevalence, aetiology and survival. Recent ISCoS frameworks provide guidance for researchers to use established classification of SCDys and age group cut-off levels in future studies, thereby improving the ability to compare and combine data.