Analysis of the Epidemiology of Traumatic Vertebral Column Injuries in Eastern European Countries

Abstract

Vertebral column fractures (VCF), despite their relatively small proportion in the overall structure of human musculoskeletal trauma, represent a significant medical and social problem. Even injuries not accompanied by neurological deficits often lead to persistent impairments in the functional capacity of the affected individuals, significantly affecting their quality of life, employability, and social activity. The epidemiology of spinal trauma is insufficiently understood, largely due to the difficulty in accurately assessing its true frequency. Existing literature on the epidemiology of vertebral column trauma is mostly based on single-center or multicenter studies focused on specific region.

Objective: To conduct a preliminary analysis of the epidemiological features of vertebral column trauma in Eastern European countries.

Materials and Methods: Statistical data from the Global Burden of Disease database were analyzed to investigate the epidemiology of spinal trauma. The study focused on countries located entirely within the European part of the Eurasian continent. A 30-year period prior to the onset of the COVID-19 pandemic (1990–2019) was selected as the optimal time frame to reflect the current state of the problem. The main analysis parameters included disease incidence and years lived with disability.

Results: It was found that the relative frequency of vertebral column trauma is higher in countries with a higher gross domestic product. Over the analyzed period, all Eastern European countries exhibited a declining trend in the relative frequency of vertebral column trauma. In the overall structure of musculoskeletal trauma, vertebral column trauma accounts for 3.5‒4.5% in Eastern European countries, and this figure is progressively increasing. Armed conflicts in the Republic of Moldova in 1992 and in Ukraine starting from 2014 are characterized by an increase in the frequency of vertebral column trauma. The proportion of males among those with vertebral column trauma is relatively stable and specific to each of the examined countries. In contrast to the conflict in Transnistria, the armed conflict in eastern Ukraine did not significantly alter the gender structure of vertebral column trauma patients, indicating a larger proportion of civilians among the affected individuals. Analysis of the causes of vertebral column injuries revealed that, on average, unintentional injuries account for approximately 81%, injuries resulting from road traffic accidents account for 16%, intentional injuries represent about 3%, with the latter two gradually decreasing. Almost half (42‒46%) of vertebral column trauma cases occur in the age group of 20‒44 years. In countries with a high gross domestic product, a significantly higher frequency of injury among elderly and senile population is recorded, possibly due to more efficient diagnostic methods.

Conclusions: Gender and age characteristics of vertebral column trauma have a relatively stable pattern specific to each of the examined countries. Numerous socio-economic and behavioral factors influence the frequency of vertebral column trauma, but the significance of these parameters requires further research.