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Ricerca Internazionale

Reliable and up-to-date data on the incidence of traumatic spinal cord injury (TSCI) are critical to monitor the causes of trauma and their changes over the past years. They are also important to focus on preventive measures and health-care planning. Only one study specifically addressed the incidence of TSCI in Italy. It was retrospective, geographically restricted, not up-to-date and focused on a limited population.1 In addition, over the past two decades, prospective studies2,3 have been based only on rehabilitation settings. With regard to other countries, in Western Europe, TSCI incidence was calculated by means of either the hospital discharge forms, the International Classification of Diseases (ICD) codes of classification or the examination of the medical records, thus resulting in a retrospective data collection over long periods of time. TSCI incidence rates vary from 10.2 cases per million per year to 23.5 cases per million per year.6–10 In North America, the estimated TSCI incidence ranges from 40 to 56 cases per million per year.4,5 The trend in the United States suggests a variation in the bimodal distribution of the age of patients with TSCI, with an increase in the population with SCI at a later age (over 60), with a greater likelihood of discharge to a nursing home and subsequent higher costs for the healthcare system. Furthermore, incomplete lesions are increasing and etiology is shifting toward a higher percentage of ground level falls as compared with the levels in road traffic accidents, especially in older population.4,11 The same is already occurring in Japan, where 75% of persons with SCI are tetraplegic and predominantly aged people,12 when compared
with the 47% in North America and Australia and the 51% in Western Europe.13 Calculating the incidence and its changes over years is, therefore, necessary for a correct allocation of resources both for prevention and for acute and rehabilitation care. Italy is included in the list of the most developed countries. For this reason, we might hypothesize that the trend of TSCI incidence in Italy might be similar to the one of other nations of this group. With this observational prospective study, based on a large population, distributed across the whole country, we aim to determine the incidence of TSCI in Italy and describe its characteristics in terms of etiology,
characteristics of the lesion and demographic characteristics of the population, with specific attention to the peculiar features of our country