Demographic Profile of Spinal Cord Injury (SCI): A Hospital-based Prospective study in Bangladesh

Atma Razzak, Rajkumar Roy, Shamim Khan


Purpose: To provide an overview of demographic characteristics of spinal cord injury (SCI) in Bangladesh.

Methods: The study was conducted between 1st January and 31st December 2012 at 5 hospitals:  Centre for the Rehabilitation of the Paralysed (CRP) in Savar, National Institute of Traumatology & Orthopaedic Rehabilitation (NITOR), Bangabandhu Sheikh Mujib Medical University (BSMMU), Rangpur Medical College Hospital, and Chittagong Medical College Hospital. 600 SCI cases from these tertiary hospitals were enrolled, and data was collected from those who met the study criteria, using a structured questionnaire developed on the basis of SCI core data set. Data was processed and analysed by SPSS version 16.

Results: The male/female ratio was 4.5:1. Mean age at injury was 34.53 years (16–83 years). The cause of SCI was falls for 34.8% and RTA for 25.5% of the clients. 83.5% of SCI was traumatic and 16.5% was non-traumatic in origin. Only 9.5% of the clients were directly admitted to tertiary hospitals while 90.5% had intermediate admission before that. One-third (33.2%) of the clients used ambulance for intra-hospital transfer. 70.5% of the injury resulted in paraplegia and 29.5% in tetraplegia. Thoraco-lumbar junction (T11-L2) was the region most commonly involved, accounting for 38.7% of all cases. Overall 58.7% SCI cases were found with complete injury (ASIA-A) and 41.3% with incomplete injury during admission. 20.8% of the clients were admitted with pressure ulcer. The study found 27.2% of cases were operated on. The in-hospital mortality rate was 3.3%.

Limitation: The pre-hospital fatalities were not included in the study. During data collection, extent of SCI was found in only 507 cases instead of all 600 enrolled.

 Conclusions: This study could contribute to the establishment of an effective prevention programme and comprehensive SCI management in Bangladesh. 


paraplegia, ASIA scale, demography, spinal cord injury

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Ackery A, Tator CH, Krassioukov A (2004). A global perspective on spinal cord injury epidemiology. J Neurotrauma; 21: 1355–1370. PMid:15672627

Agarwal P, Upadhyay P, Raja K (2007). A demographic profile of traumatic and non-traumatic spinal injury cases: a hospital-based study from India. Spinal Cord; 45: 597–602. PMid:17179974

Aito S, Tucci L, Zidarich V, Werhagen L (2014). Traumatic spinal cord injuries. Evidence from 30 years in a single centre. Spinal Cord; 52: 264-267. PMid:24492638

Alshahri SS, Cripps RA, Lee BB, Al-Jadid MS (2012). Traumatic spinal cord injury in Saudi Arabia: An epidemiological estimate from Riyadh. Spinal Cord; 50: 882–884. PMid:22777491

Bangladesh Bureau of Statistics (BBS) Statistics and Informatics Division (SID) (2011). Population and housing census 2011. Socio-economic and demographic report national series, Volume 4.

Bangladesh Spine Society (2012). Management of thoracolumbar spinal injury at a specialized centre in Bangladesh. Annual National Conference & Scientific Eeminar of Bangladesh Spine Society, Dhaka.

Biswas SK (2012). Road traffic injuries: an emerging problem in Bangladesh. Faridpur Med. Coll. J; 7(1): 05.

Burns AS, O'Connell C (2012). The challenge of spinal cord injury care in the developing world. The Journal of Spinal Cord Medicine; 35(1): 3-8. PMid:23098705

Cheng LM, Zeng ZL, Yang ZY, Zhou JQ, Yuan F, Zhang SM (2008). Epidemiologic features and effect of surgical treatment of spinal injuries treated in one medical centre. Chin J Orthop Trauma; 3: 245-248.

Chhabra HS, Arora M (2012). Demographic profile of traumatic spinal cord injuries admitted at Indian Spinal Injuries Centre with special emphasis on mode of injury: A retrospective study. Spinal Cord; 50: 745–754. PMid:22584285

Cripps RA, Lee BB, Fitzharris M, Wing PC (2014). The global map for traumatic spinal cord injury epidemiology: Update 2011, global incidence rate. Spinal Cord; 52: 110–116. PMid:23439068

DeVivo MJ (2012). Epidemiology of traumatic spinal cord injury: trends and future implications. Spinal Cord; 50: 365–372. PMid:22270188

DeVivo M, Biering-Sorensen F, Charlifue S, Noonan V, Post M, Stripling T, Wing P (2006). Executive Committee for the International SCI Data Sets Committees. International Spinal Cord Injury Core Data Set. Spinal Cord; 44: 535–540. PMid:16955073

Donovan WH (2007). Spinal Cord Injury—Past, Present, and Future. J Spinal Cord Med.; 30(2): 85-100. PMid:17591221 PMCid:PMC2031949

Gautam MP, Karki P, Rijal S, Singh R (2005). Pott's spine and Pott's paraplegia. J Nep Med Assoc; 44(159): 106–15.

Hagen EM, Eide GE, Rekand T, Gilhus NE, Gronning M (2010). A 50-year follow-up of the incidence of traumatic spinal cord injuries in Western Norway Spinal Cord; 48: 313–318.

Helal M, Hossain MA (2013). Four decades of economic development of Bangladesh: An assessment. Journal of the Asiatic Society of Bangladesh (Hum.); 58(2): 335-362.

Hoque MF, Christoph G, Kylie (1999). Spinal cord lesions in Bangladesh: An epidemiological study. Spinal Cord; 37: 858-861. PMid: 10602529

Hoque MF, Hasan Z, Razzak ATMA, Helal SU (2012). Cervical spinal cord injury due to fall while carrying heavy load on head: a problem in Bangladesh. Spinal Cord; 50: 275–277. PMid:22143680

Ibrahim A, Lee KY, Kanoo LL, Tan CH, Hamid MA, Hamedon NM, Haniff J (2013). Epidemiology of spinal cord injury in Hospital Kuala Lumpur. Spine (Phila Pa 1976) Mar 1; 38(5): 419-24.

Islam MS, Hafez MA, Akter M (2011). Characterisation of spinal cord lesion in patients attending a specialised rehabilitation centre in Bangladesh. Spinal Cord; 49: 783–786. PMid:21502957

Katoh S, Enishi T, Sato N, Sairyo K (2014). High incidence of acute traumatic spinal cord injury in a rural population in Japan. Spinal Cord; 52: 264-267. PMid:24513725

Knutsdottir S, Thorisdottir H, Sigvaldason K, Jonsson H Jr., Bjornsson A, Ingvarsson P (2012). Epidemiology of traumatic spinal cord injuries in Iceland from 1975 to 2009. Spinal Cord; 50: 123 –126. PMid:21946442

Koskinen EA, Alen A, Väärälä EM, Rellman J, Kallinen M, Vainionpää A (2014). Centralised spinal cord injury in Finland: Unveiling the hidden incidence of traumatic injuries. Spinal Cord; 52: 779-784., PMid:25112968

Kuhn W, Zach GA, Kochlin P, Urwyler A (1983). Comparison of spinal cord injury in females and in males, 1979 ± 1981 Basle. Paraplegia; 21: 154 ± 160.

Kuptniratsaikul V (2003). Epidemiology of spinal cord injuries: A study in the Spinal Unit, Siriraj Hospital, Thailand, 1997-2000. J Med Assoc Tahi; 86(12): 1116-21. PMid:14971518

Lakhey S, Jha N, Shrestha BP, Niraula S (2005). Aetioepidemiological profile of spinal injury patients in Eastern Nepal. Tropical Doctor; 35: 231-233. PMid:16354480

Manjeet S, Siddhartha S, Iftikhar WH, Agnivesh T, Farid MH, Nirdosh M, Dara S(2009). Spine injuries in a tertiary health care hospital in Jammu: A clinico-epidemiological study. Internet J Neurosurg; 5: 2.

Maynard FM, Bracken MB, Creasy G, Ditunno Jr JF, Donowan WH, Ducker TB, Garber SL, Marino RJ, Stover SL, Tator CH, Waters RL, Wilberger JE, Young W (1997). International standards for neurological and functional classification of spinal cord injury. Spinal Cord; 35.

McCammon JR, Ethans K (2011). Spinal cord injury in Manitoba; a provincial epidemiological study. J Spinal Cord Med; 34: 6-10.

Michael M, Roth K (2012). Against all odds: A qualitative study of rehabilitation of persons with spinal cord injury in Afghanistan. Spinal Cord; 50: 864-868. PMid:23032605

Najendijk JHB, Post MWM, Asbeck van FWA (2014). Epidemiology of traumatic spinal cord injuries in the Netherlands in 2010. Spinal Cord; 52: 258-263. PMid:24445971

New PW, Cripps RA, Lee BB (2013). Global non-traumatic SCI epidemiology. Spinal Cord; 1–13.

Ning G-Z, Yu T-Q, Feng S-Q, Zhou X-Z, Ban D-X, Liu Y, Jiao X-X (2011). Epidemiology of traumatic spinal cord injury in Tianjin, China. Spinal Cord; 49: 386–390. PMid:20921958

Ning G-Z, Wu Q, Li Y-L, Feng S-Q (2012).Epidemiology of traumatic spinal cord injury in Asia: A systematic review. The Journal of Spinal Cord Medicine; 35(4). PMid:22925749 PMCid:PMC3425879

Noe BB, Mikkelsen EM, Hansen RM, Thygesen M, Hagen EM. Incidence of traumatic spinal cord injury in Denmark, 1990–2012: A hospital-based study. Spinal Cord (2015); 53: 436–440. PMid:25366529

Nwankwo OE, Uche EO (2013). Epidemiological and treatment profiles of spinal cord injury in southeast Nigeria. Spinal Cord; 51: 448–452. PMid:23478671

O'Connor PJ (2005). Forecasting of spinal cord injury annual case numbers in Australia. Arch Phys Med Rehabil; 86(1): 48–51. PMid:15640988

Rahimi-Movaghar V, Sayyah MK, Akbari H, Khorramirouz R, Rasouli MR, Moradi-Lakeh M, Shokraneh F, Vaccaro AR (2013). Epidemiology of traumatic spinal cord injury in developing countries: A systematic review. Neuroepidemiology; 41: 65–85. PMid:23774577

Rathore MF, Hanif S, Farooq F, Ahmad N, Mansoor SN (2008). Traumatic spinal cord injuries at a tertiary care rehabilitation institute in Pakistan. J Pak Med Assoc; 58(2): 53–7. PMid:18333519

Razdan S, Kaul RL, Motta A, Kaul S, Bhatt RK (1994). Prevalence and pattern of major neurological disorders in rural Kashmir (India) in 1986. Neuroepidemiology; 13:113–119. PMid:8015664

Razzak A, Helal SU, Nuri RP (2011). Life expectancy after Spinal Cord Injury in a developing country – A retrospective study at CRP, Bangladesh. Disability, CBR & Inclusive Development; 22(2): 114-123.

Razzak ATMA (2013). Early Care following Traumatic Spinal Cord Injury (TSCI) in a Rehabilitation Centre in Bangladesh - An Analysis. Disability, CBR and Inclusive Development (DCID); 24(2): 64-78.

Scivoletto G, Farchi S, Laurenzal L, Molinari M (2011). Traumatic and non-traumatic spinal cord lesions: an Italian comparison of neurological and functional outcomes. Spinal Cord; 49: 391–396.,, PMid:20603629

Segun TD (2011). Spinal cord injury definition, epidemiology and pathophysiology view. Available from: [Accessed on 12 Jul 2011].

Shin CJ, Kim DH, Yu SJ, Yang HE, Yoon SY (2013). Epidemiologic change of patients with spinal cord injury; Ann Rehabil Med; 37(1): 50-56.

PMid:23525183 PMCid:PMC3604234

Shingu H, Ohama M, Ikata T, Katoh S, Akatsu T (1995). A nationwide epidemiological survey of spinal cord injuries in Japan from January 1990 to December 1992. Paraplegia; 33: 183–188., PMid:7609973

Tee JW, Chan CHP, Fitzgerald MCB, Liew SM, Rosenfeld JV (2013). Epidemiological trends of spine trauma: An Australian Level 1 Trauma Centre Study. Global Spine J; 3: 75–84. PMid:24436855 PMCid:PMC3854579

UNICEF (2011). Annual report. Available from:

Vasiliadis AV (2012). Epidemiology map of traumatic spinal cord injuries: A global overview. International Journal of Caring Sciences; 5(3): 335-347.

van den Berg MEL, Castellote JM, Mahillo-Fernandez I, de Pedro-Cuesta J (2010). Incidence of spinal cord injury worldwide: A systemic review. Neuroepidemiology; 34: 184-192. PMid:20130419

Weerts E (2009). Final reporting of project outcomes. Spinal Cord Injury care and Orthopaedic workshop. Handicap International, Hanoi, Vietnam. PMCid:PMC2682635

World Bank Data (2015). World population indicators. Available from:

World Health Organisation (2004). World report on road traffic injury prevention. Geneva Switzerland: WHO Publications.

World Health Organization (2013). International perspectives on spinal cord injury. Available from:

Wyndaele M, Wyndaele JJ (2006). Incidence, prevalence and epidemiology of spinal cord injury: What learns a worldwide literature survey? Spinal Cord; 44: 523–529. PMid:16389270


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