TREATMENT OF PATIENTS WITH SPINAL-CORD LESIONS IN GERMANY 1996 - STATE-OF-THE-ART

Modern treatment of sufferers from spinal cord lesions according to th e guidelines elaborated by Sir Ludwig Guttmann in the UK started in sp ecialised centres in Germany some 45 years ago. At the present time th e incidence is 18 cases/1 million/year traumatic and non traumatic. Ex act figures are available since 20 years ago. Twenty-one appropriate c entres with altogether 1071 beds are able to admit almost all traumati c cases and 30% of non traumatic cases for 'comprehensive treatment'. That includes cervical lesions above C4 as well as patients with polyt rauma, intensive care, spinal column surgery, sophisticated urological diagnostic and treatment, physio- and occupational therapy, psycholog ical and social assistance. To fulfil all tasks arising from lifetime care and readmissions there is a need of another 800 beds in specialis ed centres not dealing with recent cases. The original principle to of fer first treatment and life-time follow up 'under one roof is to be g iven up as conservative treatment of the broken spine has been continu ally replaced by spinal surgery done in non specialised primary admitt ing regional hospitals. Priority is given to the aim to offer similar opportunities to everyone by providing 800 additional beds in new spec ialised centres.