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Laurance Johnston, Ph.D.

Sponsor: Institute of Spinal Cord Injury, Iceland 



SCI prevalence and incidence varies throughout the world for a variety of societal reasons, including, for example, automobile usage and the availability of quality health care that allows post-injury survival. Although comprehensive data is lacking, it is  estimated that 1.5 to 5.2-million individuals with SCI are living throughout the world, including about 250,000 in the U.S., 330,000 in the Council-of-Europe member countries, and 420,000 in China. Clearly, SCI is a disorder that bows to no flag.

Motor-vehicle accidents are usually the leading cause of SCI. For example, in the US, they account for approximately 44-47% of SCI cases. For a variety of reasons (e.g., risk-taking behaviors), SCI inordinately affects young men (~80%). Due to medical and rehabilitative advances available in developed nations, people with SCI often approach a near-average live expectancy.


Because SCI typically affects young adults with near-normal life expectancy, they face immense lifetime, SCI-associated expenses, as well as compromised earnings and societal contributions. Summarized below for the U.S., the costs must be shouldered either by the individual, their family, or society.

Average Yearly Expenses (May 2006 dollars)

Severity of Injury

First Year

Subsequent Years

High Tetraplegia (C1-C4)



Low Tetraplegia (C5-C8)






Incomplete Motor Functional at any Level



Estimate Lifetime Costs by Age at Injury (discounted at 2%)

Severity of Injury

25 years old

50 years old

High Tetraplegia (C1-C4)



Low Tetraplegia (C5-C8)


$1,047, 189




Incomplete Motor Functional at any Level



In addition, there are the costs associated with lost productivity after SCI, for example, lost wages and fringe benefits. Although dependent on the injury level, and the individualís educational level and pre-injury employment, it is estimated that these costs average $59,212 per year.

In the U.S., 250,000 cases of SCI (using a mid-level $1.5-million lifetime cost) correspond to a cumulative societal cost of $375-billion.

Further documenting the personal economic impact, especially in countries that donít have universal health-care coverage, recent studies suggest that the costs associated with sustaining SCI or a traumatic brain injury increases considerably the possibility of bankruptcy. Because individuals sustaining these injuries often are unable to access adequate financial support to deal with these huge medical costs, they have to discharge their debts in bankruptcy courts. Specifically, these studies showed that in the U.S. the incidence of bankruptcy increased by 33% in the five years after injury.