The fourth edition of the ABC of Spinal Cord Injury, although now redesigned in the current ABC style, has the same goals as previous editions. It assumes spinal cord injury to be the underlying condition, and it must be remembered that a slightly different approach is used for trauma patients in whom spinal column injury cannot be excluded but cord damage is not suspected. This ABC aims to present in as clear a way as possible the correct management of patients with acute spinal cord injury, step by step, through all the phases of care and rehabilitation until eventual return to the community. The book discusses how to move the injured patient from the scene of the accident, in conformity with pre-hospital techniques used by ambulance services in developed countries, and it incorporates refinements in advanced trauma life support (ATLS) which have developed over the past decade. The text explains how to assess the patient, using updated information on the classification and neurological assessment of spinal cord injury. There is a greater emphasis in making the correct diagnosis of spinal injury and established cord injury—unfortunately, litigation due to missed diagnosis is not uncommon.
The pitfalls in diagnosis are identified, and by following the step by step approach described, failure to diagnose these serious injuries should therefore be minimised. Patients with an acute spinal cord injury often have associated injuries, and the principles involved in managing these injuries are also discussed. The later chapters follow the patient through the various stages of rehabilitation, and describe the specialised nursing, physiotherapy and occupational therapy required. They also discuss the social and psychological support needed for many of these patients in helping both patient and family adjust to what is often a lifetime of disability. Where applicable, the newer surgical advances, including the use of implants which can result in enhanced independence and mobility, are described. Later complications and their management are discussed, and for the first time there is a chapter on the special challenges of managing spinal cord injuries in developing countries, where the incidence is higher and financial resources poorer than in the developed world.
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