Injuries of all types pose a major healthcare concern in Australia. Spending on injuries is captured in the Disease expenditure database, including costs from injury hospitalisations and treatment in primary care settings. In 2021-21, a total of $150 billion was allocated to health conditions, of which 7.3% ($11 billion) was spent treating and managing injury. Injuries ranked fourth-highest in terms of spending (AIHW 2023a). Burden of disease measures the impact of illness and injury through time spent in ill health and premature death. In 2022, injuries were the 6th highest cause of total disease burden in Australia, accounting for 8% of total burden of disease (AIHW 2022).

In 2020-21, there were 1,952,000 ED presentations for injuries and 537,000 hospitalisations. Within that same year, spinal injuries contributed to 19,378, or 1% of all ED presentations and 26,556, or 4.6% of all injury related hospitalisations.

Back pain and related problems are a large contributor to illness, pain, and disability in Australia (Health Direct 2021). Data from the 2022 Australian Burden of Disease Study show that back pain and other problems accounted for just over 4% of Australia’s total disease burden (AIHW 2022), the third leading cause.

Spinal injuries can significantly impact a person’s mobility, daily activities, and overall quality of life. The impacts and health of people with chronic conditions and disability are further detailed in other AIHW publications.

Data sources

This report uses the National Hospital Morbidity Database (NHMD) to describe spinal injury cases, referred to here as hospitalisations for brevity. Emergency department (ED) data is sourced from the National Non-admitted Patient Emergency Department Care (NNAPEDC) Database. ED cases are referred to as presentations.


This report presents information on the 19,000 ED presentations and 27,000 spinal injury hospitalisations during the period 1 July 2020 to 30 June 2021. Hospitalisations data from The National Hospital Morbidity Database (NHMD) include Australian public and private hospitals in Australia, and ED presentations data from the National Non-Admitted Patient Emergency Department Care Database (NNAPEDC) include data from selected public hospitals.

In this report, spinal injuries are defined as any ED presentations, hospitalisation or death in hospital due to any external cause where the site of injury is the spine, spinal nerves or spinal cord.

For ED presentations, cases are included only where a person presented with a principal diagnosis (see box 1) of a spinal injury. ED presentations that have an end status of admitted to hospital may be counted in both the emergency department and hospitalisations data. 

For Hospitalisations, data include cases where a person was admitted to hospital with a principal or additional diagnosis of a spinal injury. Inclusion criteria for spinal injury hospitalisations are summarised below and detailed in the technical notes.

While multiple spinal injury diagnosis codes may be recorded for an ED presentation or hospitalisation, the records included in this report are generally for those where the spinal injury was the principal diagnosis (see box 1).

This report excludes information on spinal injury that did not result in emergency department presentation or hospitalisation. For each spinal injury ED presentation and hospitalisation there may be many more cases that are treated by general practitioners, allied health professionals or outpatient clinics.

This report differs from Spinal cord injury, Australia 2017–18and others in the Spinal cord injury, Australia series, which presents national statistics solely on spinal cord injury (SCI) using data from case registrations to the Australian Spinal Cord Injury Register (ASCIR). Funding for the ASCIR data collection ceased several years ago, and the last publication was on 2017–18 data.

For more detailed information on the methodology used in this report, see technical notes.

Box 1: Inclusion criteria for hospitalisations

Principal diagnosis (18,922 cases)

Where the spinal injury was recorded as the principal diagnosis: “The diagnosis established after study to be chiefly responsible for occasioning an episode of admitted patient care, an episode of residential care or an attendance at the health care establishment, as represented by a code” (AIHW METeOR 2023a).

Additional diagnosis (7,386 cases)

Where the spinal injury was recorded as an additional diagnosis: “A condition or complaint either coexisting with the principal diagnosis or arising during the episode of admitted patient care, episode of residential care or attendance at a health-care establishment, as represented by a code” (AIHW METeOR 2023b).

See technical notes for further information on the counts contributed by each type of diagnosis and ICD-10-AM code (ACCD 2019).