Incidence and aetiology of traumatic spinal cord injury in Cape Town, South Africa: a prospective, population-based study

Abstract

STUDY DESIGN: Prospective, regional population-based study. Objectives: To provide the incidence, aetiology and injury characteristics of traumatic spinal cord injury (TSCI) in the City of Cape Town, South Africa. SETTING: All government-funded hospitals within the City of Cape Town, South Africa. METHODS: All survivors of acute TSCI, given that they met the inclusion criteria, were prospectively included for a 1-year period. The International Spinal Cord Injury Core Data Set was used and systematically completed by specialist doctors. Further, international standards for neurological classification were adhered to. RESULTS: In total, 147 cases of acute TSCI were identified and 145 were included in the study. The male to female ratio was 5.9:1 and the mean age was 33.5 years, ranging from 18 to 93. The crude incidence rate was 75.6 per million (95% CI: 64.3–88.8) with assault as the main cause of injury, accounting for 59.3% of the cases, followed by motor vehicle accidents (26.3%) and falls (11.7%). Most injuries occurred in the cervical spine (53.1%), and American Spinal Injury Association Impairment Scale A severity was most common (39.3%) in the cohort. CONCLUSION: The incidence rate of TSCI in a region of South Africa was high when compared to previously postulated figures for the country. There is a need for primary preventative strategies to target younger men that are exposed to violent activities. A national study is required to learn whether these findings are only locally applicable or generalisable.