[Post-inpatient after-care of paraplegic patients: selected internal medicine aspects]

In-hospital rehabilitation of para-/tetraplegic patients is followed by the family doctor's long-term surveillance supported by annual checkups in the rehabilitation clinic. The family doctor bears a heavy burden of responsibility. Loss of sensation may cover a wide range of complications. Most of these functional disorders are the consequence of reduced physical activity and a disturbed autonomic nervous system. There is a significantly high incidence of pulmonary infection, in particular pneumonia and atelectasis, coronary heart disease, autonomic dysreflexia, urinary tract infections, kidney stones, renal and hepatic insufficiency, gallstones, constipation and ileus, as well as decubitus, osteoporosis and so on. Chronic severe pain and spasm also require optimum therapy, in view of their potential to reduce quality of life and working capacity. This article provides an overview of several relevant problems in internal medicine involving diagnosis, therapy and long-tem surveillance of patients with spinal cord injuries.