摘要Background Spinal cord injury is a catastrophic medical condition and a growing global public health priority,with divergent etiologies,risk factors,and epidemiology.Comprehensive analyses of trends in pediatric spinal cord injury burden both in China and globally are lacking.Methods We investigated temporal trends in pediatric spinal cord injury burden[incidence,prevalence,and years lived with disability(YLDs)]from 1990 to 2021 and projected future burden to 2045 using Global Burden of Disease(GBD)2021 data.The year with the most significant changes in trends was identified via joinpoint regression analysis.Age-standardized rates,average annual percentage changes(AAPC),and subgroup analyses by injury location,sex,age,and sociodemographic index were calculated.To project burden data to 2045,we employed a Bayesian age-period-cohort model.Results Our analyses revealed that global pediatric spinal cord injury incidence[AAPC:-1.13;95％confidence interval(CI):-1.49 to-0.76],prevalence(AAPC:-1.13;95％CI:-1.16 to-1.11),and YLDs rates(AAPC:-1.37;95％CI:-1.41 to-1.35)decreased significantly from 1990 to 2021.The highest burden was observed in males,adolescents(15-19 years),and high-sociodemographic index regions;falls were the leading cause.China exhibited similar declining trends(e.g.,inci-dence AAPC:-1.33;95％CI:-1.71 to-0.83).It is predicted that by 2045,the global trend of pediatric spinal cord injury will decline;China will exhibit an upward trend.Conclusions Persistent disparities in pediatric spinal cord injury disease burden and causes necessitate targeted prevention strategies,optimized rehabilitation services,and equitable resource allocation.This is particularly important in high-risk groups and regions with rising burdens.