Epidemiological Trends and Neurological Patterns of Spinal Cord Injury and Related Disorders in an Iraqi Spinal cord injury hospital: A Retrospective Study from 2003 to 2026

Abstract

Background: Spinal cord injuries (SCIs) and disorders are neurological conditions that impose a long-term health and functional burden, as they cause long-term motor and sensory deficits, a decline in independence and quality of life, and an ongoing need for specialized medical and rehabilitative services. Studying these conditions in the Iraqi context is particularly important, given the overlap between traditional traumatic injuries and those associated with violence, war, and non-traumatic medical causes. Objective: This study aimed to characterize the demographic, etiological, and neurological features of cases of spinal cord injuries and disorders referred to a referral rehabilitation center in Iraq, analyze changes in their patterns over time, and identify factors associated with the most severe neurological pattern at admission. Methodology: A retrospective observational study was conducted at the Ibn al-Kuaff Spinal cord injury hospital in Baghdad, based on a long-term database spanning from 2003 to the end of the study period. The study included 4,873 unique records, and the data underwent cleaning and standardization of clinical and etiological terminology. Demographic, etiological, and neurological variables were analyzed, and temporal trends were examined using binary logistic regression, along with statistical comparisons and a multivariate logistic regression model. Results: The results showed a clear male predominance at 92.1%, with a median age of 32 years. Injuries related to violence and war were the most common cause at 32.6%, followed by non-traumatic/medical causes, then falls and road traffic accidents. SCI was predominantly of the paraplegic type (85.0%), compared to 14.2% for quadriplegia/tetraplegia. The temporal analysis also showed a significant decline in annual admissions, with a clear shift in the distribution of causes across time periods. In the multivariate analysis, age was the only factor independently associated with an increased likelihood of quadriplegia, although the model’s explanatory power remained limited. Conclusion: The study reveals a substantial and time-varying rehabilitation burden for spinal cord injuries and disorders in Iraq, characterized by a male predominance, a concentration in working-age adults, and a prominence of injuries associated with violence and war. The findings support the need for more detailed national registries linking epidemiological characteristics to long-term functional outcomes.