Global Epidemiology of Pediatric Traumatic Spine Injury: A Systematic Review and Meta-Analysis.

OBJECTIVE: Traumatic spine injury (TSI) leads to significant morbidity and mortality in children. However, the global epidemiology of pediatric TSI is currently unknown. We conducted a systematic review and meta-analysis to estimate the global incidence of pediatric TSI and burden of cases.

METHODS: PubMed, Embase, and Scopus were searched for articles in June 2021 and updated in March 2023 with no restriction on language and year of publication. A meta-analysis was conducted to estimate the global incidence of pediatric traumatic spine injury (TSI) and subsequently the number of cases of pediatric TSI worldwide and proportion requiring spine surgery.

RESULTS: Of 6,557 articles, 25 studies met the inclusion criteria. Road traffic accidents (64%) were responsible for the majority of cases reported in the literature followed by falls (18%). The global incidence of TSI in children ≤ 20 years old was estimated to be 14.24/100000 amounting to 375,734, with an estimated 114,975 requiring spine surgery. Across World Bank income classification groups, lower MICs had the highest pediatric TSI case burden (186,886 cases with 57,187 requiring spine surgery). Across WHO Regions, countries in the Southeast Asia Region (SEAR) had the largest number of projected cases at 88,566 with 27,101 requiring surgical management, followed closely by the African Region (AFR) with 87,235 projected cases with 26,694 requiring surgical management.

CONCLUSION: Pediatric TSI represents a large healthcare burden globally. Interventions targeting both injury prevention and neurosurgical capacity strengthening, especially in low resource settings, are needed to address this global health challenge.