OPERATIVE AND NONOPERATIVE MANAGEMENT OF SPINAL-CORD INJURY - A REVIEW

Technological developments over the last two centuries have advanced t he spinal surgeon's capability to service the needs of spinal cord inj ured person. While the role that surgery can play in shortening hospit alization for tetraplegics has yet to be proven, it does play a much n eeded role in the correction of instability and prevention of deformit y when the possibility of these conditions exist. Surgical interventio n for purposes or neural decompression has yet to be proven as justifi able in view of the risks involved. All surgical procedures must be un dertaken only after due consideration of the patients' general medical condition, including coexisting trauma, the potential for and actual instability and deformity of the spine, and the neurological level and degree of incompleteness of the patient. In general, the greater the remaining neurological function, the more there is to gained by early mobilization. Yet, in the face of progressive improvement in neurologi cal function, caution is advised since there will be much to lose if a nything goes wrong with the operation.