Key points

  • Many of the complications such as pressure sores occur as a result of a failure to provide adequate support to the sensory impaired disabled individual.
  • A simple procedure such as a POP back-slab could seriously hamper the independence of the patient. A return to home following management of an acute illness in the DGH should include careful and informed reappraisal of the needs of the patient. For example carpal-tunnel release cannot be carried out as a day case for a wheelchair dependent paraplegic.

Liaise with your local Spinal Injuries Unit for further advice.

Recommended reading:

ABC of Spinal Cord Injury by Grundy D, Swain A, London, BMJ Publishing Group, 1996.

The First 48 Hours, Harrison P, Princess Royal Spinal Injuries Unit, Published by Spinal Injuries Association, ISBN 0-9531237-3-1.

Managing Spinal Cord Injury/Critical Care, Harrison P, Princess Royal Spinal Injuries Unit, Published by Spinal Injuries Association, ISBN 0-9531237-8-2.

Further reading:

Management of Spinal Cord Injuries, In: Postgraduate Textbook of Clinical Orthopaedics, Frankel H L, Ravichandran G, Ed. Harris & Birch, Blackwell Science, 1995, pages1129-1164.

Pathophysiology of Acute Spinal Cord Injury, In: Spinal Cord Injuries – Anaesthetic & Associate Care, Ravichandran G, Ed. Alderson JD, Frost E.A.M., Butterworth, 1990, pages 1-19.

Currrent concepts: Spinal Injuries and Rehabilitation.W S El Masri(y) and D J Short, Current Opinion in Neurology 1997, 10:484-492

The Neurologic Outcome in conservatively treated patients with incomplete closed traumatic cervical spinal cord injuries.
Katoh, S El Masry W S , Jaffray D , McCall I, Eisenstein S, Pringle, R Pullicino V and Ikata T, SPINE (1996) vol 21, no 20, p 2345-2351

Recent Developments in the Management of Injuries of the Cervical Spine:W S El Masry and D Jaffray. Handboof of Clinical Neurology Vol 17 (6), 1992, Vinken and Bruyn, Editor: H L Frankel

Reflections on the Neurological Significance of Bony Canal Encroachment following Traumatic Injury of the Spine in Patients with Frankel C, D and E presentation. W S El Masry, S Katoh, A Khan. ABSTRACT: 2nd International Neurotrauma Symposium, Glasgow (July 1993). Journal of Neurotrauma vol 10, supp 1 (1993).

Does ‘Canal Clearance’ Affect Neurological Outcome after Thoraco-lumbar burst fracture? Boerger T O, Limb D, Dickson R A, JBJS, (2000) 82B, 629-635.

High Dose Methylprednisolone in the Management of Acute Spinal Cord Injury – A Systematic Review from a Clinical Perspective, Short D T, El Masri W S, Jones P W, Spinal Cord (2000) 38, 273-286.