Abstract
The fundamentals of care in spinal cord injury were laid down many years ago. Prevention → therapy → follow up is basic in medicine. In spinal cord injury, admission to a comprehensive unit then application of simple, repetitive disciplines for patient and staff, and education are the fundamentals to be emphasised. The great pioneers, Munro, Guttmann and Botterell achieved advances long before sophisticated technology moved to a stage when now it could swamp the fundamentals of care. Such fundamentals include admission to truly comprehensive units catering for acute care but, more importantly, lifetime care with acceptance of the fundamental medical axis of prevention, therapy and follow up. The details of fundamental care include secondary and tertiary prevention techniques in hospital and community, and an acceptance by staff as well as spinal men and women of their simplicity, their repetitiveness, the need for disciplined action and the requirement for education at all levels. In the future, primary prevention must be given more emphasis as cure is many decades away even with the volume of basic research now being undertaken.
Article PDF
References
Munro D (1943) Thoracic and lumbo-dorsal injuries. J Am Med Assoc 122: 1055–1063.
Guttmann L (1973) Spinal Cord Injuries. Comprehensive Management and Research. Blackwell Publications, Oxford.
Botterell E H (1978) Spinal cord injury. Parts I & II. J R Coll Surg Edinb 23: 57–64, 107–116.
Bedbrook G M (1959) Spinal injuries-a challenge. Aust NZ J Surg 28: 245–256.
Pasteur quoted (1989) in: An introduction to national head and spinal cord injury prevention programs. American Association of Neurological Surgeons, Congress of Neurological Surgeons.
Bedbrook G M (1985a) A balanced viewpoint in the early management of patients who have neurological damage. Paraplegia 23: 8–15.
Johnsson R, Herrlin K, Hägglund G, Strömqvist B (1991) Spinal canal remodelling with intraspinal bone fragments. Acta Orthop Scand 62(2): 125–127.
Frankel H (1987) Spinal cord injury units. Paraplegia 24: 239–240.
Bedbrook G M (1984) Lifetime Care of the Paraplegic Patient. Churchill Livingstone, London.
Pearman J (1971) Prevention of urinary tract infection following spinal cord injury. Paraplegia 9: 95–104.
Sussman B J (1978) Fracture dislocations of the cervical spine. A critique of current management in the United States. Paraplegia 16: 15–38.
Chahal A S (1975) Care of spinal cord injuries in the Armed Forces of India. Paraplegia 13: 25–28.
Ikata T (1987) Resettlement and employment of paraplegic patients in Japan. Paraplegia 25: 308–309.
Beer N (1985) Who gets pressure sores? Far East, South Pacific Spinal Injury Conference: 103–109.
Bedbrook G M (1985b) Spinal Man - Lee Oration. J W Pacific Orthop Assoc 22: 1–10.
Young J (1982) One riot—one ranger. Editorial. Spinal Cord Injury Digest (Summer): 1–2.
Bedbrook G M (1991) Update on spinal paralysis - a preventable injury - a surgical challenge. Aust NZ J Surg 61: 478–481.
Jackson R W (1987) Sport for the paralysed person. Paraplegia 25: 301–304.
Bedbrook G M, Beer N I E, McLaren R K (1985) Preventive measures in the tertiary care of spinal cord injured people. Paraplegia 23: 69–17.
Hope M E, Kailis S K, Finucane P J (1991) Quadriplegic centre—Western Australia: a residence for those with spinal disabilities. Aust Disabil Rev 2: 46–53.
Menzies Foundation Technical Reports. (1987) No 1: Toward Prevention of Spinal Cord Injury. (1988) No 2: Towards a Registry for the Prevention of Spinal Cord Injury. Melbourne, Australia.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bedbrook, G. Fifty years on fundamentals in spinal cord injury care are still important. Spinal Cord 30, 10–13 (1992). https://doi.org/10.1038/sc.1992.6
Issue Date:
DOI: https://doi.org/10.1038/sc.1992.6