Early Therapeutic, Social and Vocational Problems in the Rehabilitation of Persons with Spinal Cord Injuries

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Dr. Marian Weiss’ textbook reviewing the etiology, pathophysiology, philosophy and conservative vs. surgical management of spinal and spinal cord injury is a significant contribution to the world literature. The remarks which follow are intended to serve the reader as a surgeon’s ‘thumb nail’ sketch of the text’s contents, along with brief comments on areas of agreement or mild variance of the opinions expressed. Dr. \Veiss’ statement that the average surgical team often becomes more emotionally involved with the good or doubtful prognosis case at the expense of the victim with a hopeless prognosis, is totally valid. The percentage number of surgical spinal cases are insignificant when compared with the number of surgical admis sions. As a result, little appropriate knowledge is amassed by the average surgeon to allow for competence or confidence in the management of the spinal injured patient’s total problems. The opinion is correct that spinal trauma should be managed in Spinal Injury Centers where access to the entire array of specialists required by quadriplegic or paraplegic victims is available. Such comprehensive programs are most appro priately affiliated with University Medical Centers.