Musculoskeletal morbidity in adults with spinal cord injuries: A nationwide cohort study

Article type: Research Article

Authors: Bae, Youngoh^{a; b; c; †} | Jung, Hohyun^{d; e; †} | Shin, Nakyung^d | Rahmati, Masoud^{f; g; h} | Udeh, Raphaelⁱ | Kazemi, Abdolreza^h | Li, Yusheng^{j; k} | Solmi, Marco^{l; m; n; o} | Syafrudin, Muhammad^p | Fitriyani, Norma Latif^p | Fond, Guillaume^{f; q} | Boyer, Laurent^{f; q} | Lee, Seung Won^{b; *}

Affiliations: [a] Department of Neurosurgery, Pohang Naval Hospital, Pohang, Korea | [b] Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea | [c] Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea | [d] Department of Statistics, Sungshin Women’s University, Seoul, Korea | [e] Data Science Center, Sungshin Women’s University, Seoul, Korea | [f] CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France | [g] Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran | [h] Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran | [i] School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, NSW, Australia | [j] Deparment of Orthopedics, Xiangya Hospital, Central South University, Hunan, China | [k] National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China | [l] Department of Psychiatry, SCIENCES Lab, University of Ottawa, Ottawa, ON, Canada | [m] Department of Mental Health, Regional Centre for the Treatment of Eating Disorders and On Track: The Champlain First Episode Psychosis Program, The Ottawa Hospital, Ottawa, ON, Canada | [n] Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada | [o] Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany | [p] Department of Artificial Intelligence and Data Science, Sejong University, Seoul, Korea | [q] FondaMental Foundation, Créteil, France

Correspondence: [*] Correspondence to: Seung Won Lee, MD, PhD, Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Korea. Tel.: +82 31 299 6163; Fax: +82 50 4478 0201; E-mail: lsw2920@gmail.com. ORCID: https://orcid.org/0000-0001-5632-5208

Note: [†] Youngoh Bae and Hohyun Jung contributed equally to this work.

Note: [1] Youngoh Bae: https://orcid.org/0000-0002-1226-1414.

Note: [2] Hohyun Jung: https://orcid.org/0000-0002-8460-5933.

Note: [3] Nakyung Shin: https://orcid.org/0009-0009-2560-3362.

Abstract: BACKGROUND:An increase in the demand for quality of life following spinal cord injuries (SCIs) is associated with an increase in musculoskeletal (MSK) pain, highlighting the need for preventive measure research. OBJECTIVE:This study aimed to evaluate the incidence and hazards of MSK morbidities among Korean adults with SCIs, as well as the influence of SCI location on MSK morbidities. METHODS:Patient populations were selected from Korean National Health Insurance Service data (n = 276). The control group included individuals without SCIs (n = 10,000). We compared the incidences and determined the unadjusted and adjusted hazard ratios (HRs) of common MSK morbidities (osteoarthritis, connective tissue disorders, sarcopenia, myalgia, neuralgia, rheumatoid arthritis, myositis, and musculoskeletal infections) based on the location of injury (cervical, thoracic, or lumbar). RESULTS:Adults with SCIs had a higher incidence of MSK morbidity (48.45% vs. 36.6%) and a lower survival probability than those without SCIs. The incidence of MSK morbidity and survival probabilities were not significantly different for cervical cord injuries, whereas both measures were significantly different for thoracic and lumbar injuries. CONCLUSION:SCI increases the risk of MSK morbidity. Lumbar SCI is associated with a higher incidence and risk of MSK morbidity than are cervical or thoracic SCIs.

Keywords: Retrospective studies, adults, spinal cord injuries, musculoskeletal diseases, location of spinal cord injuries

DOI: 10.3233/NRE-230263

Journal: NeuroRehabilitation, vol. 54, no. 4, pp. 599-610, 2024