1University of North Carolina School of Medicine, Chapel Hill.
2Department of Neurosurgery, University of North Carolina Hospitals, Chapel Hill, North Carolina.
Neurosurg Focus. 2022 Sep;53(3):E11. doi: 10.3171/2022.6.FOCUS22255.
During the mid-1900s, military medicine made historical advancements in the diagnosis, stabilization, and treatment of spinal cord injuries (SCIs). In particular, World War II was an inflection point for clinical practice related to SCIs because of the vast number of devastating injuries to soldiers seen during World War I (WWI). The unprecedented rate of SCI along with growth in the field served as a catalyst for surgical and interdisciplinary advancements through the increased exposure to this challenging pathology. Initially, a tragic fate was assumed for soldiers with SCIs in WWI resulting in a very conservative approach strategy given a multitude of factors. However, soldiers with similar injuries 20 years later saw improved outcomes with more aggressive management interventions by specialists in spine trauma, who applied measures such as spinal traction, arthrodesis, and internal fixation, and with the significant developments in the complex rehabilitation of these patients. This article describes the historical shift in the management of SCIs through the two world wars. These historical lessons of SCI and the fundamental advances in their neurosurgical intervention have molded not only military but also modern civilian treatment of SCI.
在 20 世纪中期，军事医学在脊髓损伤（SCI）的诊断、稳定和治疗方面取得了历史性的进展。特别是，第二次世界大战（WWII）是与 SCI 相关的临床实践的转折点，因为在第一次世界大战（WWI）中看到了大量对士兵的毁灭性伤害。前所未有的 SCI 发生率以及该领域的增长通过增加对这种具有挑战性的病理的接触，成为外科和跨学科进步的催化剂。最初，由于多种因素，WWI 中患有 SCI 的士兵被认为会有悲惨的命运，因此采用了非常保守的治疗策略。然而，20 年后，脊柱创伤专家对类似损伤的士兵进行了更积极的治疗干预，应用了脊柱牵引、关节融合和内固定等措施，同时对这些患者进行了复杂的康复治疗，取得了显著进展。本文通过两次世界大战描述了 SCI 管理的历史转变。这些 SCI 的历史教训和神经外科干预的基本进展不仅塑造了军事医学，也塑造了现代民用 SCI 的治疗方法。
