Identification of TSCI

SCI is defined as damage to the spinal cord that temporarily or permanently causes functional change. TSCI occurs when the damage is caused by acute external physical impact (Ahuja et al., 2017). TSCI cases were identified mainly using medical terms in Chinese (“spinal fractures”, “cervical fractures”, “thoracic fractures”, “lumbar fractures”, “sacral fractures”, “spinal cord injury”, “cervical spine fracture with spinal cord injury”, “thoracic spine fracture with spinal cord injury”, “lumbar spine fracture with spinal cord injury”, “cervical spinal cord injury”, “thoracic spinal cord injury”, “lumbar spinal cord injury”, “cauda equina injury”, “nerve injury”, “quadriplegia”, “paraplegia”, “incomplete quadriplegia”, and “incomplete paraplegia”), as it was difficult to unify case codes because of diversities in codes used by different hospitals. The Tenth Revision of the International Classification of Diseases codes (Clark and Marshall, 2022) involving TSCI from the International Spinal Cord Injury Community Survey Group was also used to complement and refine the medical terms [S12 (fracture of the neck), S12.0 (fracture of first cervical vertebra), S12.2 (fracture of other specified cervical vertebra), S13.0 (traumatic rupture of cervical intervertebral disk), S13.2 (dislocation of other and unspecified parts of neck), S13.4 (sprain and strain of cervical spine), S14 (injury of nerves and spinal cord at neck level), S14.0 (concussion and edema of cervical spinal cord), S14.1 (other and unspecified injuries of cervical spinal cord), S17 (crushing injury of neck), S19 (other and unspecified injuries of neck), S22 (fracture of ribs, sternum and thoracic spine), S22.0 (fracture of thoracic vertebra), S23.1 (dislocation of thoracic vertebra), S24 (injury of nerves and spinal cord at thorax level), S24.0 (concussion and edema of thoracic spinal cord), S24.1 (other and unspecified injuries of thoracic spinal cord), S28 (crushing injury of thorax and traumatic amputation of part of thorax), S29 (other and unspecified injuries of thorax), S32 (fracture of lumbar spine and pelvis), S32.0 (fracture of lumbar vertebra), S33.1 (dislocation of lumbar vertebra), S34.0 (concussion and edema of lumbar spinal cord), S34.1 (other injury of lumbar spinal cord), S34.3 (injury of cauda equina), S38 (crushing injury and traumatic amputation of part of abdomen, lower back and pelvis), S39 (other and unspecified injuries of abdomen, lower back and pelvis), T02.0 (fractures involving head with neck), T02.1 (fractures involving thorax with lower back and pelvis), T04.1 (crushing injuries involving thorax with abdomen, lower back and pelvis), T04.2 (crushing injuries involving multiple regions of upper limbs), T06.0 (injuries of brain and cranial nerves with injuries of nerves and spinal cord at neck level), T06.1 (injuries of nerves and spinal cord involving other multiple body regions), T09.3 (injury of spinal cord, level unspecified), T09.4 (injury of unspecified nerve, spinal nerve root and plexus of trunk), T91.1 (sequelae of fracture of spine), T91.3 (sequelae of injury of spinal cord), G82 (paraplegia and tetraplegia), G82.0 (flaccid paraplegia), G82.1 (spastic paraplegia), G82.2 (paraplegia, unspecified), G82.3 (flaccid tetraplegia), G82.4 (spastic tetraplegia), G82.5 (tetraplegia, unspecified), G83.4 (cauda equina syndrome)] (Gross-Hemmi et al., 2017). All cases were checked by trained investigators.