Fifty years on fundamentals in spinal cord injury care are still important

The fundamentals of care in spinal cord injury were laid down many years ago. Prevention----therapy----follow up is basic in medicine. In spinal cord injury, admission to a comprehensive unit then application of simple, repetitive disciplines for patient and staff, and education are the fundamentals to be emphasised. The great pioneers, Munro, Guttmann and Botterell achieved advances long before sophisticated technology moved to a stage when now it could swamp hensive units catering for acute care but, more importantly, lifetime care with acceptance of the fundamental medical axis of prevention, therapy and follow up. The details of fundamental care include secondary and tertiary prevention techniques in hospital and community, and an acceptance by staff as well as spinal men and women of their simplicity, their repetitiveness, the need for disciplined action and the requirement for education at all levels. In the future, primary prevention must be given more emphasis as cure is many decades away even with the volume of basic research now being undertaken.