A review of treatment of spinal cord injury.

Spinal cord injury remains a devastating event to the person sustaining the injury. Not only the cost of acute and rehabilitation care, but also the loss of productivity of the victims who are often young men injured at a highly productive period of their lives are a costly illness for society as a whole. In the past 20-30 years, there has been continual improvement in the morbidity and mortality from spinal cord injury with the improvement in prevention of a second injury, prevention of secondary renal, pulmonary and cutaneous complications, better techniques for stabilization of the spinal column, and more effective utilization of remaining neurological function with improved rehabilitation therapy. It remains, however, difficult to demonstrate an effect from a wide range of 'acceptable' medical or surgical care on the resultant loss of spinal cord function. The lack of improvement in preventing or reversing the loss of spinal cord function in spite of marked variations in acute spinal cord injury care indicate that acceptable data are still lacking to determine the role of aggressive and conservative management. The need for a more organized approach to the problem is obvious.