Evolving Demographics and Injury Characteristics of US Traumatic Spinal Cord Injury, 1972-2024

To examine demographic and injury characteristics of new traumatic spinal cord injury (tSCI) cases from 1972 to 2024, contextualized by US population trends.

Cross-sectional analysis of a longitudinal database.

Thirty-one Spinal Cord Injury Model Systems (SCIMS) centers throughout the United States.

A total of 37,866 SCIMS database participants grouped into 6 injury cohorts (1972-1979 to 2020-2024).

Not applicable.

Demographics (age, sex, race/ethnicity, education, employment, marital status) and injury characteristics (cause, level, completeness).

Mean age at injury increased from 28.7 years in the 1970s to 44.7 years in 2020-2024, with individuals aged ≥65 years rising from 3.1% to 19.9%. This trend was consistent across sexes, race/ethnicity groups, and injury causes except violence. Hispanic ethnicity increased from 6.0% to 16.1%, and postsecondary education from 7.5% to 31.7%. The proportion retired, married, and widowed rose, while student and single status declined; however, within age groups, single/never-married proportions increased, mirroring US population trends. Vehicular crashes, though still the leading cause, declined from 47.0% to 36.0%, whereas falls nearly doubled from 16.5% to 32.5%. Violence-related injuries increased in 2020-2024, especially among individuals aged 15-44 years. High cervical injuries rose from 14.8% to 33.9%, and motor-incomplete injuries increased from 36.6% to 57.3%. Subgroup analyses of 4 continuously contributing centers confirmed these trends.

Study findings highlight the need to integrate geriatric care into acute and rehabilitative services and to prioritize fall-prevention among older adults. The recent increase in violence-related injuries warrants targeted surveillance and intervention. Rising education and motor-incomplete injuries may improve long-term outcomes. Monitoring marital status trends is important for understanding social participation and quality of life after tSCI.