Issn Print: 0362-2436

Publication Date: 2001/10/15


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Frank J. Eismont

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Excerpt

This is a simple straightforward article. The authors have documented the fact that the time from spinal cord injury to the time the patient can be mobilized in a wheelchair is shortest if the patient can be treated in a regional spinal cord injury center. They also have shown that the complication rate can be decreased with treatment in a high-volume spinal cord injury center.
It should not be a surprise that clinicians with much experience managing an uncommon medical problem generally will produce a better outcome with fewer complications in a shorter time. Surgeons represent only a small part of the care required by spinal cord injured patients. Nurses, therapists, psychologists, and other medical specialists also expedite the progress of these patients along the proper treatment pathway. The authors emphasizes this fact by showing that the patients at the spinal cord injury center were taken to surgery later than the patients at other hospitals, yet still were mobilized earlier.
One weak point of this report is that although its data are true for the authors’ spinal cord injury center and their referral base, the information may not hold true for other centers. The second weakness of the article is that the patients who underwent surgery at other hospitals and then were referred to the authors’ spinal cord injury center may have been a biased sample. These issues need to be addressed to achieve maximum validity.

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