Paralysis

True Life: I'm Living with Paralysis (A Day in the life of 28 Year Old)

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• published: 06 Dec 2011
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It is estimated that the annual incidence of spinal cord injury (SCI), not including those who die at the scene of the accident, is approximately 40 cases per million population in the U. S. or approximately 12,000 new cases each year. Since there have not been any incidence studies of SCI in the U.S. since the 1990′s it is not known if incidence has changed in recent years. The number of people in the United States who are alive in 2010 who have SCI has been estimated to be approximately 265,000 persons, with a range of 232,000 to 316,000 persons. SCI primarily affects young adults. From 1973 to 1979, the average age at injury was 28.7 years, and most injuries occurred between the ages of 16 and 30. However, as the median age of the general population of the United States has increased by approximately 9 years since the mid-1970, the average age at injury has also steadily increased over time. Since 2005, the average age at injury is 40.7 years. Other possible reasons for the observed trend toward older age at injury might include changes in either referral patterns to model systems, the locations of model systems, survival rates of older persons at the scene of the accident, or age-specific incidence rates. Overall, 80.7% of spinal cord injuries reported to the national database have occurred among males. Over the history of the database, there has been a slight trend toward a decreasing percentage of males. Prior to 1980, 81.8% of new spinal cord injuries occurred among males. A significant trend over time has been observed in the racial/ethnic distribution of persons in the database. Among persons injured between 1973 and 1979, 76.8% were Caucasian, 14.2% were African American, and 0.9% were Asian. However, among those injured since 2005, 66.5% are Caucasian, 26.8% are African American, and 2.0% are Asian. Hispanic increased from 5.9% in 1970's to 12.5% in 2000-2004 and 8.3% since 2005. This trend is due in part to trends in the United States general population and also possibly explained by the changing locations of model systems, referral patterns to model systems, or race-specific incidence rates. Since 2005, motor vehicle crashes account for 40.4% of reported SCI cases. The next most common cause of SCI is falls, followed by acts of violence (primarily gunshot wounds). The proportion of injuries that are due to sports has decreased over time while the proportion of injuries due to falls has increased. Violence caused 13.3% of spinal cord injuries prior to 1980, and peaked between 1990 and 1999 at 24.8% before declining to only 15.0% since 2005. Persons with tetraplegia have sustained injuries to one of the eight cervical segments of the spinal cord; those with paraplegia have lesions in the thoracic, lumbar, or sacral regions of the spinal cord. Since 2005, the most frequent neurologic category at discharge of persons reported to the database is incomplete tetraplegia (39.5%), followed by complete paraplegia (22.1%), incomplete paraplegia (21.7%) and complete tetraplegia (16.3%). Less than 1% of persons experienced complete neurologic recovery by hospital discharge. Over the last 15 years, the percentage of persons with incomplete tetraplegia has increased while complete paraplegia and complete tetraplegia have decreased slightly. More than half (57.3%) of those persons with SCI admitted to a model system reported being employed at the time of their injury. At one year after injury, 11.6% of persons with SCI are employed. By 20 years post-injury, 35.2% are employed and a similar level of employment is observed through post-injury year 30.