Traumatic Spinal Cord Injury Mortality in the United States, 1999–2024

OBJECTIVES: Traumatic spinal cord injury (TSCI) is associated with substantial disability and mortality, yet its mortality patterns remain unclear. We aimed to evaluate trends and disparities in TSCI mortality in the United States from 1999 to 2024. METHODS: This retrospective study analyzed data from the CDC WONDER database. Trends in age-adjusted mortality rates (AAMRs) were analyzed using Joinpoint regression to estimate annual percentage changes and average the annual percentage change. Changes in AAMRs were compared across prepandemic (2018-2019), pandemic (2020-2022), and postpandemic (2023-2024) periods. RESULTS: Among 43,034 TSCI deaths, the AAMR did not change significantly over time; however, nonlinear temporal fluctuations were observed, including a decline from 2006 to 2010, followed by sustained increases thereafter. AAMRs were consistently higher among men, older adults (65 years or older), and non-Hispanic Black or African American (NH Black) individuals, with increasing trends observed in older adults and the Midwest. During and after the pandemic, AAMRs increased overall, with the greatest increases observed among women (+13.73%), older adults (+18.45%), NH Black individuals (+11.19%), and the Northeast (+21.55%). DISCUSSION: Stable overall mortality masked underlying temporal trends and demographic disparities, underscoring the need for targeted prevention strategies and equitable access to trauma care and rehabilitation services.