1124 Shifting Trends in the Epidemiology of Cervical Spine Injuries: An Analysis of 11,822 Patients From the National Electronic Injury Surveillance System (NEISS) Over Two Decades

INTRODUCTION: Cervical spine injuries (CSIs) are heterogeneous in nature and often lead to long-term disability and morbidity. However, there are few recent and comprehensive epidemiological studies on CSI. METHODS: The National Electronic Injury Surveillance System (NEISS) was used to extract data on CSIs from 2002-2022. Patient narratives were used to categorize injury etiology (i.e. fall), and to identify CSI level. K-means clustering was performed on cervical levels to define upper vs lower cervical injuries. RESULTS: A total of 11,822 patient records met the study criteria with a mean age of 62.4 ± 22.7 years, 52.4% of whom were male, 61.4% of whom were white, 7.4% were black, 27.8% were not specified, the remaining comprised a variety of ethnicities. The most common mechanism of CSI was a fall (67.3%). There was a significant increase in the incidence of cervical injuries between 2003-2022 (p<0.001). Unbiased K means clustering defined upper cervical injuries as C1-C3 and lower cervical injuries as C4-C7. The mean age of patients with upper CSIs was 72.3 ± 19.6, significantly greater than the age of those with lower CSIs (57.1 ± 23.1, p<0.001). Compared with lower CSI, white patients were more likely to have an upper CSI (73.7 vs. 67.4% p<0.001). While Black/African American (7.5% vs. 3.8%) and Hispanic (2.5% vs 1.0%) patients were more likely to have a lower CSI (p<0.001). CONCLUSIONS: Our study identified a significant increase in the incidence of CSIs over time which was associated with increasing patient age. We detected a pragmatic demarcation of classifying upper injuries as C1-C3 and lower cervical injuries as C4-C7. Upper injuries were seen more often in older, white females and lower injuries were seen more often in young, black male patients.