Global, regional, and national burden trends of spinal fractures from 1990 to 2021: a population-based study

Spinal fractures have become a significant cause of health loss and an increasing disease burden due to their high incidence and disability risk. However, the current understanding of the disease burden and its trend remains limited, which hinders the effectiveness of public health interventions.

Data for this study were sourced from the standardized Global Burden of Disease (GBD) 2021 database. Various analytical methods, including trend analysis, correlation analysis, age-period-cohort analysis, frontier analysis, health inequality analysis, and predictive analysis, were used to explore the current status and trends of the disease burden associated with spinal fractures.

From 1990 to 2021, the age-standardized rate (ASR) of spinal fractures globally showed a downward trend, and this trend is expected to continue in the future. However, the absolute number of spinal fracture cases has steadily increased. Since 2018, the rate of decline in the age-standardized prevalence rate and years lived with disability has slowed. In 2021, there were 7.4975 million new cases of spinal fractures globally, with 5.3714 million existing patients, resulting in 546 000 years lived with disability. Significant disease burden inequalities were observed across different regions, with a notable increase in the burden as the Socio-Demographic Index (SDI) rises. High-SDI regions and countries faced the most severe disease burden. The ASR remained low for individuals under 60 years of age, with both the ASR and actual cases higher in males than females. For individuals aged 60 years and above, the ASR significantly increased, with females surpassing males. The ASR shows an overall decreasing trend across different genders and age groups, but the absolute inequality is greater in men than in women. Additionally, falls, other exposures to mechanical forces, and motor vehicle road injuries were the leading causes of spinal fractures.

Although the ASR of spinal fractures has significantly decreased, the absolute number of patients continues to rise, and heterogeneity exists across countries, regions, age groups, genders, and over time. These findings highlight the need for more targeted and personalized public health interventions in the future.