Epidemiology of War-Related Spinal Cord Injury Among Combatants: A Systematic Review.

Global Spine J

Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada.

Published: August 2019

AI Article Synopsis

  • The systematic review focused on war-related spinal cord injuries (SCIs), finding they are generally more severe and complex than civilian SCIs.
  • Researchers analyzed 1,594 publications from 1946 to 2017, ultimately including 25 studies that provided insights into the demographics, injury mechanisms, and incidence of war-related SCIs.
  • Key findings indicated that most affected military personnel are young, white men, frequently suffering from complete SCIs primarily due to gunshot wounds or explosions, with a higher risk observed among Marines compared to other military branches.

Article Abstract

Study Design: Systematic review.

Objectives: War-related spinal cord injuries (SCIs) are commonly more severe and complex than traumatic SCIs among civilians. This systematic review, for the first time, synthesized and critically appraised the literature on the epidemiology of war-related SCIs. This review aimed to identify distinct features from the civilian SCIs that can have an impact on the management of military and civilian SCIs.

Methods: Medline, EMBASE, and PsycINFO databases were searched for articles on epidemiology of war-related SCI among combatants, published from 1946 to December 20, 2017. This review included only original publications on epidemiological aspects of SCIs that occur during an act of war. The STROBE statement was used to examine the quality of the publications.

Results: The literature search identified 1594 publications, of which 25 articles fulfilled the inclusion and exclusion criteria. The studies were classified into the following topics: 17 articles reported demographics, level and severity of SCI, mechanism of injury and/or associated bodily injuries; 5 articles reported the incidence of war-related SCI; and 6 articles reported the frequency of SCI among other war-related bodily injuries. Overall, military personnel with war-related SCI were typically young, white men, with predominantly thoracic or lumbar level, complete (American Spinal Injury Association [ASIA] Impairment Scale A) SCI due to gunshot or explosion and often associated with other bodily injuries. Marines appear to be at a greater risk of war-related SCI than the military personal in the Army, Navy, and Air Force.

Conclusions: The war-related SCIs among soldiers are distinct from the traumatic SCI in the general population. The majority of the current literature is based on the American experiences in most recent wars.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686388PMC
http://dx.doi.org/10.1177/2192568218776914DOI Listing

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