Objective  To analyze the burden of spinal cord injury (SCI) in China and its trends from 1990 to 2021.

Methods  Data on the incidence and prevalence of SCI were obtained from the 2021 Global Burden of Disease Study database. Joinpoint regression models were employed to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to assess the temporal trends in the burden of SCI. Subsequently, age-period-cohort model analysis was conducted to evaluate the net effects of age, period, and cohort on disease burden, and to predict the trends in the burden of SCI from 2022 to 2050.

Results  In 2021, the number of newly diagnosed SCI cases in China was 99,400, and the total number of cases was 2.7663 million, representing an increase of 43.27% and 63.27%, respectively, compared to 1990. From 1990 to 2021, the age-standardized incidence rate (ASIR) of SCI in China [AAPC=-0.02, 95%CI (-0.29, 0.34)] and the age-standardized prevalence rate (ASPR) [AAPC=0.09, 95%CI (0.00, 0.15)] showed no significant trend of change. The number of prevalent and incident cases of SCI in China was highest among individuals aged 50–59 years. Age-period-cohort analysis revealed that the age-specific relative risk (RR) values for SCI incidence in China showed an upward trend, while the age-specific RR values for prevalence first increased and then decreased. The period-specific RR values for the incidence and prevalence of SCI in China show a consistent trend, with an overall upward trend. The cohort effect RR values for the incidence and prevalence of SCI in China show a consistent trend, with an overall increase followed by a decrease. It is projected that by 2050, the ASIR of SCI will decrease to 4.46 per 100,000, while the ASPR of SCI in China will increase to 245.48 per 100,000.

Conclusion  Between 1990 and 2021, the absolute number of SCI cases in China increased significantly, while the age-standardized rates (ASR) remained stable. The burden on males continued to be higher than that on females. Interventions targeting high-risk factors in the elderly population should be strengthened to further reduce the disease burden of SCI in China.

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