Epidemiologic changes in nontraumatic spinal cord injury for the last 30 years (1990–2019) in South Korea

Study design Retrospective descriptive study. Objectives To summarize epidemiologic data on nontraumatic spinal cord injury (NTSCI) for the last 30 years and compare these findings to data from individuals with traumatic spinal cord injury (TSCI). Setting National Rehabilitation Center affiliated with the Ministry of Health and Welfare in Korea. Methods The medical records of 948 individuals with NTSCIs were retrospectively reviewed. Three groups were created based on onset period (1990–1999, 2000–2009, 2010–2019) and six groups based on age (≤15, 16–30, 31–45, 46–60, 61–75, and ≥76 years). Pearson’s chi-square and analysis of variance tests were used for statistical analysis. Results The male-to-female ratio was 1.30:1 for NTSCI individuals and 3.47:1 for TSCI individuals. The mean age (standard deviation [SD]) at the time of injury increased from 38.7 (SD = 18.1) years in the 1990s to 55.5 (SD = 16.6) years in the 2010s ( F = 44.597, p ≤ 0.001). Vertebral column degenerative disorder was the primary cause of injury in 28.9% of the cases, and the most common neurologic level was T12-L2. Paraplegia occurred in 74.6% of cases, and tetraplegia in 25.4% of cases. The proportion of NTSCI individuals increased from 11.2% to 29.3% during the observation period. Conclusions The proportion of NTSCI among total spinal cord injuries has increased in Korea over the last 30 years (1990–2019). Compared to individuals with TSCI, those with NTSCI had a higher age at onset, with different male-to-female ratios. Our study is the most comprehensive investigation of NTSCI in Korea, and our findings can inform research directions and medical guidelines.