[What has spinal stabilization contributed for the paraplegic patient?]

The aim of spondylodesis is to restore the injured spinal column to its previous shape and stability. In the transverse SCI patient, it entails easier intensive care in case of multiple injury as well as easier general nursing tasks, and greater intensity of physiotherapy in the acute and early phases. Compared to conservative management of the injured spinal column, mobilization is effected some 21 to 39 days earlier in surgical patients, total hospitalization in tetraplegics is shortened by 5 days, and by 34 to 57 days in paraplegic patients. Functionally valuable neurological recovery in primary complete paralysis occurs in 19%/20% of conservative/surgical cases, in primary partial paralysis in 67%/58%. Stabilization of the spinal column however does not at the same time achieve a stabilization of the transverse SCI patient's entire situation--physical, psychological, social. Irrespective of the scope of paralysis, the advantages of a spondylodesis should be considered also in case of total paraplegia. Conservative management retains its importance in cases where surgery is not indicated, or even contraindicated. Comparable results are very rarely achieved outside the specialized centres. Acute cases of SCI should therefore be referred to spinal centres as soon as possible, which for their part have to be able to admit patients 24 hours a day, as well as to provide adequate care until completion of the entire treatment.