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us race economic status pervasive associations mechanisms injury severity injury management outcomes trauma goal current study examine relationships large scale setting pediatric spinal injury admissions spinal fracture without spinal cord injury sci spinal dislocation sci without radiographic abnormality identified kids inpatient database kid national trauma data bank ntdb registry 2009 patients ranged age birth 21 years data kid used estimate nationwide annual incidences data ntdb used describe patterns injury relation age race payor corroboration kid multiple logistic regression used model rates mortality spinal fusion 2009 estimated incidence hospital admission spinal injury us 170 per 1 million population 21 years age incidence sci 24 per 1 million incidences varied regionally adolescents predominated patterns injury varied age race payor black patients severely injured patients races measured injury severity scale scores among black patients spinal injury ntdb 239 suffered firearm injuries 1 white patients suffered firearm injuries overall mortality rate ntdb 39 multivariate analysis included large panel clinical nonclinical factors black race retained significance predictor mortality p 0006 adjusted 1571 11412163 rates spinal fusion associated race payor ntdb data payor kid patients better insurance underwent spinal fusion higher rates epidemiology pediatric spinal injury us cannot understood apart considerations race economic status