Follow-up care of para-/tetraplegics: selected aspects in internal medicine

In-hospital rehabilitation of para-/tetraplegic patients is followed by the family doctor's longterm surveillance supported by annual checkups in the rehabilitation clinic. The family doctor bears a heavy burden of responsibi lity. Loss of sensation may cover a wide range of complications. Most of th ese functional disorders are the consequence of reduced physical activity a nd a disturbed autonomic nervous system. There is a significantly high inci dence of pulmonary infection, in particular pneumonia and atelectasis, coro nary heart disease, autonomic dysreflexia, urinary tract infections, kidney stones, renal and hepatic insufficiency, gallstones, constipation and ileu s, as well as decubitus, osteoporosis and so on. Chronic severe pain and sp asm also require optimum therapy, in view of their potential to reduce qual ity of life and working capacity. This article provides an overview of several relevant problems in internal medicine involving diagnosis, therapy and long-tem surveillance of patients with spinal cord injuries.