title: Epidemiology of traumatic spinal cord injury in developing countries: a systematic review.
abstract: OBJECTIVE
  To describe the epidemiology of spinal cord injury (SCI) in the developing world.
  
  
  METHODS
  Developing countries were selected based on the definition proposed by the International Monetary Fund. A literature search was performed in July 2012 in Medline and Embase. Further article procurement was obtained via the reference lists of the identified articles, websites, and direct contact with the authors of the identified studies. We designed search strategies using the key words: SCI, epidemiology, incidence, and prevalence. According to the inclusion criteria, 64 studies from 28 countries were included.
  
  
  RESULTS
  The incidence of SCI in developing countries is 25.5/million/year (95% CI: 21.7-29.4/million/year) and ranges from 2.1 to 130.7/million/year. Males comprised 82.8% (95% CI: 80.3-85.2) of all SCIs with a mean age of 32.4 years (95% CI: 29.7-35.2). The two leading causes of SCI were found to be motor vehicle crashes (41.4%; 95% CI: 35.4-47.4) and falls (34.9%; 95% CI: 26.7-43.1). Complete SCIs were found to be more common than incomplete injuries (complete SCI: 56.5%; 95% CI: 47.6-65.3; incomplete SCI: 43.0%; 95% CI: 34.1-52.0). Similarly, paraplegia was found to be more common than tetraplegia (paraplegia: 58.7%; 95% CI: 51.5-66.0; tetraplegia: 40.6%; 95% CI: 33.3-48.0).
  
  
  CONCLUSIONS
  Through an understanding of the epidemiology of SCI in developing countries, appropriate preventative strategies and resource allocation may decrease the incidence and improve the care of these injuries.
authors.affiliation: Sina Trauma and Surgery Research Center, Department of Neurosurgery, Shariati Hospital, Tehran, Iran. v_rahimi@sina.tums.ac.ir
authors.forename: Vafa
authors.initials: V
authors.lastname: Rahimi-Movaghar
authors.forename: Mohammad Kazem
authors.initials: MK
authors.lastname: Sayyah
authors.forename: Hesam
authors.initials: H
authors.lastname: Akbari
authors.forename: Reza
authors.initials: R
authors.lastname: Khorramirouz
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Rasouli
authors.forename: Maziar
authors.initials: M
authors.lastname: Moradi-Lakeh
authors.forename: Farhad
authors.initials: F
authors.lastname: Shokraneh
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Vaccaro
mesh_terms: D003906:Developing Countries / Q000191:economics; D006760:Hospitalization / Q000191:economics / Q000639:trends*; D006801:Humans; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology*