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September 2010

Up the Spinal Canal Without a PaddleConsideration of Neurology's Role in Spinal Cord Injury

Author Affiliations

Author Affiliations: Spinal Cord Injury Research, Crawford Research Institute, Shepherd Center; and Departments of Neurology and Physiology, Emory University, Atlanta, Georgia.

Arch Neurol. 2010;67(9):1053-1054. doi:10.1001/archneurol.2010.202

In this issue of the Archives, Dr New1 advocates for a diagnosis-specific care path for patients with nontraumatic myelopathy and a multidisciplinary team approach to carry out this care, much as it is done for traumatic spinal cord injury (SCI). As he indicates, specialized care, coordinated from trauma to rehabilitation, has significantly improved the overall outcomes and quality of life for patients with traumatic SCI over the past several decades.2 There is now a commonly applied set of clinical practice guidelines for these patients that can be downloaded for free from the Paralyzed Veterans of America Web site (http://www.pva.org/site/PageServer?pagename=pubs_generalpubs#cpg). Specialty training to care for these patients is also available through SCI medicine fellowships, and trainees can become subspecialty board–certified.3 Unlike patients with traumatic SCI, patients with nontraumatic myelopathy often do not receive SCI-specific care and, unfortunately, do not fare as well. There are several reasons for this, and neurologists are partly responsible. It is, therefore, imperative that neurologists increase their knowledge about SCI, both traumatic and nontraumatic, and increase their participation in the care of these patients as part of the multidisciplinary team for which Dr New advocates.

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