• Wyatt L Ramey, Christina M Walter, Jeffrey Zeller, Travis M Dumont, G Michael Lemole, and R John Hurlbert.
• Department of Surgery, Division of Neurosurgery, Banner University of Arizona Medical Center, Tucson, Tucson, Arizona.
• Neurosurgery. 2019 Sep 1; 85 (3): E502-E508.

BackgroundThe border between the United States (US) and Mexico is an international boundary spanning 3000 km, where unauthorized crossings occur regularly. We examine patterns of neurotrauma, health care utilization, and financial costs at our level 1 trauma center incurred by patients from wall-jumping into the US.ObjectiveTo determine the clinical and socioeconomic consequences from neurotrauma as a result of jumping over the US-Mexico border wall.MethodsMedical records of patients at (Banner University of Arizona Medical Center - Tucson) were retrospectively reviewed from January 2012 through December 2017. Demographics, clinical status, radiographic findings, treatment, length of stay, and financial data were analyzed for all patients suffering neurotrauma during that time.ResultsOver 6 yr, 64 patients sustained cranial or spinal injuries directly from jumping or falling onto US soil from the border wall. Fifty (78%) suffered spinal injuries, 15 (23%) experienced cranial injury, and 1 patient had both. Total medical charges were available in 36 patients and summed $3.6 M, of which 22% was reimbursed, an amount significantly lower than expected from more conventional trauma. Neurotrauma steadily declined over the 6-yr observation period, dropping in 2017 to 6% of rates observed in 2012.ConclusionIn the Southern US, neurotrauma from unauthorized border crossings occurs commonly as a result of wall-jumping. These injuries represent a clinical and costly extreme of border-related trauma, and future efforts from both sides of the border wall are needed to decrease the detrimental impacts felt both by immigrants and surrounding health care systems.Copyright © 2019 by the Congress of Neurological Surgeons.

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