Epidemiology of spinal cord injury in children and adolescents.

OBJECTIVE: To describe the unique aspects of the epidemiology of pediatric-onset spinal cord injury (SCI).
METHODS: The characteristics of persons with SCI enrolled in either the Shriners Hospitals for Children SCI database or the National SCI Statistical Center database from 1973 through 2002 were evaluated based on age at time of injury (0-5 years, 6-12 years, 13-15 years, 16-21 years, and 22 years and older).
RESULTS: Males comprised a consistently decreasing proportion of new cases of SCI, ranging from 83% among persons between 16 and 21 years of age to only 51% among those aged 0 to 5 years. Among children and adolescents (under the age of 22), the proportion of SCI due to motor vehicle crashes was higher than in adults (22+ years). Sports, violence, and medical or surgical complications also accounted for a significantly greater proportion of SCI in teenagers (13-21 years) than in adults. Violence has become the leading cause of SCI among African American and Hispanic teenage males (13-21 years), whereas vehicular crashes are more common among African American and Hispanic men of older ages (22 years of age and above). Approximately one third of new cases of SCI in the youngest two age groups (0-5 years, 6-12 years) had cervical injuries compared with almost one half in the older age groups (age 13 and above). SCI was much more likely to be neurologically complete in younger persons (69% age 0-5 years vs 51% age > or = 16 years).
CONCLUSION: The pediatric-onset SCI population is heterogeneous and exhibits distinct epidemiologic characteristics both within the different pediatric age groups and with the adult-onset SCI population.