Increasing Incidence of Cervical Spine Injuries in the United States: An Age- and Sex-specific Analysis of National...

This study analyzes cervical spine injuries using the National Electronic Injury Surveillance System (NEISS), a database representing ~100 US emergency departments (EDs), over a 10-year period.

To identify the distribution of cervical spine injuries in US EDs to inform clinical management and prevention strategies.

Understanding the epidemiology and trends of cervical spine injuries is essential for improving clinical management and developing prevention strategies.

NEISS was queried for all cases involving neck fractures, sprains, and strains. An automated text analysis program was used to exclude injuries unrelated to the cervical spine. Data collection was restricted to injuries recorded between January 1, 2014 and December 31, 2023.

From 2014 to 2023, a total of 14,293 cervical spine injuries were identified, resulting in a national estimate (NE) of 622,517 over the study period. Annual rates of cervical spine injury increased significantly (P=0.021, β=2838, 95% CI: [553, 5,122]), peaking in 2019 (NE 84,561, 13.6% of all injuries). Cervical spine injuries led to hospitalization 23.2% of the time. Hospitalization rate was higher among males than females (25.7% vs. 21.0%, P<0.0001), and only males had a significant increase in cervical spine injuries over the study period. Among age groups, ages 65-84 accounted for the largest number of injuries (NE 163,960, 26.4% of all injuries), and 80-year-olds presented with more cervical spine injuries than any other year (NE 9819). Ages 85 and older had the highest hospitalization rate (50.8%), and ages 0-13 had the lowest (1.6%).

Cervical spine injuries are significantly increasing in the United States, particularly in males and those aged 65-84. Future research should be focused on the mitigation of cervical spine injuries, as well as home-focused preventative strategies for the aging population of the United States.