Surgical injury of the cord and its roots

Fifty-two patients sustained spinal cord, nerve root or combined injury following treatment conducted primarily by neurological and orthopaedic surgeons. Most patients did not receive the benefit of appropriate conservative treatment. Correct diagnosis was usually not arrived at even though diagnostic studies were performed sufficiently well to permit such diagnosis. Surgical treatment fell below standard in 86% of the cases in which the issue of adequacy was relevant. Post-operative care was also generally inadequate. The surgeons often failed to detect, diagnose, or reoperate promptly and properly for post-operative paralysis. These adverse results were not related to isolated surgical mishaps, to natural course of the disease, or to the inevitable result of treatment. They stem from a general failure of the surgeon to meet his responsibilities as a practitioner. There are both medical and social implications of this finding.