Sports - USA

Tator et al. 1991
N=117

Canada and United States

Canada=110
United States=6
Unknown=1

1966-1987
Survey results from physicians and other sources reporting spinal or spinal cord injury in hockey player.
Exclusion Criteria:
Minor spinal injuries such as strains, sprains, flexion-extension injuries and whiplash.

Males=96%
Mean age=21 (11-47) years
Mortality=5 (4%)

Cervical=93 (80%)
Thoracic=3 (3%)
Thoracolumbar=7 (6%)
Lumbosacral=6 (5%)
Unknown=8 (7%)
Complete=29 (25%)
Incomplete=32(27%)
Root injury only=12 (10%)
No neurological deficit=28 (24%)
Unknown=16 (14%)

Ice Hockey:
100% (n=117)

Torg et al. 1990
N=979

United States

1976-1987
National Football Head and Neck Injury Registry

Note: Rules prohibiting head first tackling and blocking introduced in 1976.

 (n=720):
Male= 100%
No details given.

Cervical spine fractures/subluxations/dislocations=720
158 (21.9%) of these injuries resulted in tetraplegia.

American Football:
73.5% (n=720)

Prevalence:
Per 100,000 players/1987
SCI: 2.3
Tetraplegia:
0.73

Cantu & Mueller 2003
N=223

United States

1977-2001
All permanent cervical spinal cord injury collected at national level from all organized football
Programs
National Center for Catastrophic Sports Injury Research

Males=100%
183 high school, 29 college,
7 professional,
4 sandlot
71% playing defense
69% tackles

Fracture/dislocation
= 176 (79%)
Cord contusion
= 31 (14%)
Acute disc rupture
= 11 (5%)

American Football:

Prevalence:
Per 100,000 players:
1991-2001
0.52 in high school
1.55 in college
14 in professional

Boden et al. 2006
N=196

United States

1989-2002
Catastrophic cervical injuries in high school and collegiate football programs reported to National Center for Catastrophic Sports Injury Research

Male=100%
150 (76.5%) high school and 46 (23.5%) collegiate.
Average age at injury=17 (range 14-28) years

93 (48.2%) permanent neurologic deficit, 100 (51.8%) no residual neurologic deficits
16 (8.2%) C1/C2 level
17 (8.6%) incomplete

American Football:

Prevalence:
Per 100,000 players:
1.10 in high school
4.72 in college

Injury Prevention Service, Oklahoma Department of Health 2006
SCI=2312

Oklahoma
USA

1988-2003
Admissions to Oklahoma hospitals with SCI due to sports; Patients who died at scene.

Football:
Males=100%
Ages 15-24 years=68%
No mortality

Incomplete tetraplegia=44
Incomplete paraplegia=9

Football:
2.3% (n=53)

Injury Prevention Service, Oklahoma Department of Health 2006
SCI=2312

Oklahoma
USA

1988-2003
Admissions to Oklahoma hospitals with SCI due to sports; Patients who died at scene.

Diving:
Males=86.4%
Ages 15-24 years=53%
Females=12
Mortality=3

Complete tetraplegia=35
Incomplete tetraplegia=47
Incomplete paraplegia=3

Diving:
3.8% (n=88)

Calancie et al. 2005
N=229

Dade County, Florida, USA

Acute traumatic spine and/or spinal cord injury admitted to Jackson Memorial Hospital

Male = 74.6%
Average age at injury
=40.0±17.5 years
15 were children

ASIA A = 32.8% (75)
ASIA B = 4.8% (11)
ASIA C = 24.0% (55)
ASIA D = 31.5% (72)
ASIA E = 7.0% (7.4)
Fractures:
Cervical = 62%
T1-T10 = 15% (35)
T11-L4 = 19% (44)
Non-fractures:
Cervical = 3% (7)
Complete = 32.8%

Diving:
5.2%
(n=12)

Thurman et al. 1994
N=223

Utah, USA

1989-1991
Utah residents with SCI in Statewide reporting system of the Utah Department of Health, Bureau of Epidemiology.

Males=76%
Median age=29 years

128 (57%) tetraplegia
95 (43%) paraplegia
41 (18%) fatal
21 (9%) died before hospital admission
110 (49%) Frankel A/B/C
46 (21%) Frankel D
25 (11%) returned to full neurological function

Diving:
4.9%
(n=11)

Acton et al. 1993
N=644

Arkansas, USA

1980-1989
Arkansas residents in Arkansas State Spinal Cord Commission registry.
Exclusion Criteria:
Lesions caused by degenerative disease; people who died at scene.

Males=80%
Mean age males=32.4 years
Mean age females=35.4 years

Tetraplegia=61
Paraplegia=9

Diving:
8.5%
(n=55)

Fassett et al. 2007
N=412

Philadelphia, Pennsyl-vania,
USA

1978-2005
Treated in Delaware Valley Regional Spinal Cord Injury Center at Thomas Jefferson University Hospital

≥70 years old. No further demographics given.

High quadriplegic  (C4 and above)=42%
Paraplegic=22%
ASIA  A ~ 45%
ASIA B ~ 13%
ASIA C ~ 15%
ASIA D ~ 24%

Diving:
1%
(n=4)

Injury Prevention Service, Oklahoma Department of Health 2006
SCI=2312

Oklahoma
USA

1988-2003
Admissions to Oklahoma hospitals with SCI due to sports; Patients who died at scene.

Horseback Riding:
Males=66.7%
Mortality=2

Complete paraplegia=1
Incomplete tetraplegia=15
Incomplete paraplegia=15

Horse riding:
1.4%
(n=33)

Goebert et al. 1991
N=59

Hawaii, USA

1987-1989
Traumatic injury
Patient at the Rehabilitation Hospital of the Pacific

Male=84.7%
Mean age
=20.2 years
0-15years=5.2%
16-30 years=44.8%
31-45 years=25.9%
46-60 years= 12.1%
61-90 years=12.1%

High Tetraplegia (C1-4)=16.2%
Low Tetraplegia (C5-8)=45.9%
High Thoracic (T1-6)=18.9%
Low Thoracic (T7-12)=10.8%
Lumbar (L1-5)=8.1%
Frankel Grades:
Complete (A)=50.8%
Motor functional (D)=35.6%

Sports:
19.0%
(n=11)

Diving: (64%)
Surfing: (9%)

Price et al. 1994
N=376

Oklahoma,
USA

1988-1990
SCI cases in Oklahoma statewide multilevel surveillance system
Exclusion Criteria:
Non Oklahoma residents; patients who died at scene; injuries to nerve roots or spinal plexus.

Males=80%
15-19 years=66 (18%)
20-29 years=110 (29%)
30-59 years=145 (39%)
≥60 years =43 (11%)
Mortality=30 (8%)

Complete tetraplegia=55 (15%),
Incomplete tetraplegia=157 (42%)
Complete paraplegia=59 (16%),
Incomplete paraplegia=105 (28%)

Sports:
11.1%
(n=42)

Diving (43%)
Horse riding (19%)
Football (17%)
Other (21%)

Calancie et al. 2005
N=229

Dade County, Florida, USA

Acute traumatic spine and/or spinal cord injury admitted to Jackson Memorial Hospital

Male = 74.6% (175)
Female = 24% (54);

Average age at injury=40.0±17.5 years
15 were children

ASIA A = 32.8% (75)
ASIA B = 4.8% (11)
ASIA C = 24.0% (55)
ASIA D = 31.5% (72)
ASIA E = 7.0% (7.4)
Fractures:
Cervical = 62%
T1-T10 = 15% (35)
T11-L4 = 19% (44)
Non-fractures:
Cervical = 3% (7)
Complete = 32.8%

Sports:
3.5%
(n=8)

Bicycle
2.6% (n=6)
Water-related
2.6% (n=6)

Acton et al. 1993
N=644

Arkansas, USA

1980-1989
Arkansas residents in Arkansas State Spinal Cord Commission registry.
Exclusion Criteria:
Lesions caused by degenerative disease; people who died at scene.

Males=80%
Mean age males=32.4 years
Mean age females=35.4 years

Tetraplegia=61
Paraplegia=9

Sports:
11.3%
(n=73)

Prevalence:
6.15/million/yr (males)
0.53/million/yr (females)

Griffin and Opitz 1985
N=154

Olmsted County, Minnesota, USA

1935-1981
Medical records-linkage system of
the Rochester Project at the Mayo Clinic, periodic multi-centre surveys

Males=72%
153 White, 1 Black

56.5% (n=87) cervical
31.8% (n=49) thoracic
9.1% (n=14) lumbar
2.6% (n=4) sacral

Sports:
7.8% (n=12)

Injury Prevention Service, Oklahoma Department of Health 2006
SCI=2312

Oklahoma
USA

1988-2003
Admissions to Oklahoma hospitals with SCI due to sports; Patients who died at scene.

Males=86%
Age Range: 7-82 years.
Mortality=10 (4%)

Survivors:
Complete tetraplegia=42 (17%)
Complete paraplegia=9 (4%)
Incomplete tetraplegia=152 (60%)  Incomplete paraplegia=49 (19%)

Sports:
11.3% (n=262)

Prevalence:
0.5/100,000/ year

Macciocchi et al. 2008
N= 298

South-eastern USA

2004-2005
All patients admitted for traumatic SCI between the ages 16-59. Excluded if unable to speak English.

Males=79%
Mean age =28.7±10.1 years.
74% of all eligible patients.

C1-4 ASIA A-C, n=9
C1-4 ASIA D, n=5
C5-8 ASIA A-C, n=30
C5-8 ASIA D, n=6
T1-8 ASIA A-C, n=26
T1-8 ASIA D, n=2
T9-12 ASIA A-C, n=15
T9-12ASIA D, n=3
L1-S3 ASIA A-C, n=5

Sports:
13%
(n=39)

Thurman et al. 1994
N=223

Utah, USA

1989-1991
Utah residents with SCI in Statewide reporting system of the Utah Department of Health, Bureau of Epidemiology.

Males=76% Median age=29 years

128 (57%) tetraplegia
95 (43%) paraplegia
41 (18%) fatal
21 (9%) died before hospital admission
110 (49%) Frankel A/B/C
46 (21%) Frankel D
25 (11%) returned to full neurological function

Sports: (excluding diving)
10.8% (n=24)

Woodruff & Baron 1994
N=150

West Virginia, USA

1985-1988
Data collected during the West Virginia Spinal Cord Injury Registry, includes only injured patients surviving until hospitalization

Male= 82%
Majority of individuals were between 15-24.

56% tetraplegia
44% paraplegia

Sports:
8% (n=12)

National Spinal Cord Injury Statistical Center 2000
N=19648

USA

1973 -1990’s
24 federally funded Model SCI Care Systems and National SCI Database

Males=81.7% 55% within 16-30 years old, mean age at injury is 31.8 years

Tetraplegia = 51.7%
Paraplegia = 46.7 %
Complete Tetraplegia = 18.5%
Incomplete tetraplegia =  29.5%
Complete Paraplegia = 27.9%
Incomplete Paraplegia = 21.3%

Sports:
7.1% (n=1395)

DeVivo et al. 1992
N=6563

USA

Admissions to Spinal Cord Injury Care Systems within 1 year of injury from:
1978-1980
N=1784

Mean age=28.4 years
Males=82.4%
Females=17.6%

Frankel grade at discharge:
Complete=51.8%
Sensory=13.7%
Motor nonfunctional=7.2%
Motor functional=25.9%
Recovered=1.4%

Sports:
15.0% (n=268)

1981-1983
N=1391

Males=82.7%
Mean age=30.5 years

Frankel grade at discharge:
Complete=57.2%
Sensory=11.7%
Motor nonfunctional=7.8%
Motor functional=22.5%
Recovered=0.8%

Sports:
13.7% (n=191)

1984-1986
N=1433

Males=84.5%
Mean age=31.2 years

Frankel grade at discharge:
Complete=48.6%
Sensory=16.2%
Motor nonfunctional=11.0%
Motor functional=23.5%
Recovered=0.6%

Sports:
14.4% (n=206)

Ditunno et al. 1985
N=56

Philadelphia, USA

Traumatic onset of SCI, aged 16-50 without brain trauma.

Males=94.3% 53% of the subjects were between 20-29 years of age.

Not given.

Sports:
14%
(n=8)

National Spinal Cord Injury Statistical Center 2005
N=23,683

USA

2000-2005
National Spinal Cord Injury Database from 25 Model SCI Care Systems

Males=79.6%
Average age of injury=37.6 years
62.9% Caucasian
22% African American
12.6% Hispanic
51.8% single

Incomplete tetraplegia (34.5%)
Complete tetraplegia (18.4%)
Incomplete paraplegia (17.5%)
Complete paraplegia (23.1%)

Sports:
8.9% (n=2108)

Nobunaga et al. 1999
N=25,054

USA

1973-1998
Admissions to a Model Spinal Cord Injury Care System within 365 days of injury.

Males=81.5%
Mean age =32.3±15.8 years.

Complete tetraplegia=44.0%
Incomplete tetraplegia=45.1%
Complete paraplegia=5.4%
Incomplete tetraplegia=4.9%

Sports:
11.1% (n=2781)