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Background: There is a paucity of reliable data regarding epidemiology of spinal cord infarction in population-based studies.Objectives: To determine the incidence of spinal cord infarction using a population-based design.Methods: Medical records and neuroimaging data of all patients with spinal cord infarction from Stearns and Benton Counties, Minnesota, between January 1st, 2010 and May 31st, 2014 were reviewed. Patients with a first-time diagnosis of spinal cord infarction were categorized as primary or secondary depending upon underlying etiology was identified. We calculated the incidences of primary and secondary spinal cord infarction adjusted for age and sex based on the 2010 US census. The severity of deficits at presentation were classified according to ASIA Impairment Scale (AIS).Results: A total of 8 spinal cord infarctions were identified among 136,654 resident populations, 5 were primary spinal cord infarctions in this population-based study. Three secondary spinal cord infarctions were observed secondary to aortic graft placement, embolic phenomenon and aortic arterial disease. The severity of deficits based on AIS were B(n=2), C(n=3) and D(n=3). The age- and sex-adjusted incidence of spinal cord infarction was 1.33 [95% confidence interval (CI) 0.6 -2.5] per 100, 000 person-years. The age- and sex-adjusted incidence of primary and secondary spinal cord infarction was 0.83 [95% confidence interval (CI) 0.3 - 1.8] and 0.49 [95% confidence interval (CI) 0.1 - 1.3 per 100, 000 person-years. The location of infarction was classified as cervical, (c7-t1 in 1, c7-t6 in 1 , c7-t2 in 1 ) thoracic (t8 in 1, t10-t11 in 1, t9 level to conus medullaris in 1, t10 level to conus medullaris in 1) and lumbar( L1 in 1.) patients respectively. No case fatality was observed at 1 month.Conclusions: We provide incidence rates for spinal cord infarction to assist in further studies and resource allocation.