Acute spinal cord injury patients--who cares?

Pertinent aspects of the remarkable advances instituted and developed for the management of patients who have sustained serious spinal injuries are discussed in this communication, and the responsibilities of medical doctors and others who care for such patients is taken up in relation to some of the recent advances in our knowledge, both experimental, and clinical. There are new challenges in investigations and therapy to be considered, some of which are being somewhat precipitiously put into practice. In particular, early spinal operations, where certain closed or open reduction procedures are followed by some of the newer forms of vertebral column fixation, may cause complications. Also the apparent benefits from such techniques may not be achieved and a plea is made for careful well documented accounts to be assembled and where possible set out, using modern statistical methods, to be made by doctors treating such patients. The significance of a full understanding of the importance of modern rehabilitation techniques for spinal cord injury patients is stressed; and finally, the practical realisation of insurance claims and of possible medical litigation is mentioned.