Key points

  1. 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.
  2. 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.