Management of acute spinal cord injuries.

This report describes the results achieved in 144 patients with spinal cord injury admitted during the period 1974 to 1979 to the Acute Spinal Cord Injury Unit of Sunnybrook Medical Centre in Toronto. Several innovations have been made. These are based on a systems analysis approach to care and documentation. It includes epidemiologic studies of, and programs for, urologic and respiratory management and the use of halo devices. The unit has achieved a marked reduction in both mortality and morbidity. Patients have been transferred to the unit earlier after trauma and have been discharged earlier to rehabilitation hospitals partly because of the coordination of the acute and rehabilitation phases of care. There has been a marked reduction in the cost of care, because of fewer complications and a shorter stay in the acute hospital. The study confirms the advantages of regionalization and specialization in the field of acute spinal cord injury.