Spinal cord injury (SCI) is a devastating injury and always looked as a disaster and end of life. We have progressed significantly from “an ailment not to be treated” psychology. The literature is full of articles on various issues pertaining to vertebral fracture and SCI but very few comprehensive care books.
This book is divided into various sections. Each chapter has clearly defined learning objectives. The chapter is broken into many subheadings. Each heading and subheading is well supported with tables, figures and highlighted “points to remember.” Each chapter ends with key points as a summary to the chapters so one can draw lessons with a detailed description in the chapter. The introduction includes the historical perspective, pathophysiology and disease burden of SCI. Section II details the prehospital and acute care, imaging protocols and management of the specific type of vertebral fractures. The vertebral fractures associated with osteoporosis, tumor and infection are discussed as a separate section. The association of vertebral fracture with other injuries and in ankylosis spondylitis, polytraumas and pediatric and geriatric age group is covered in details. The SCI management section describes evaluation protocol of spinal cord injured patient to predict the final outcome. Each issue such as neurogenic, bowel bladder, respiration, cardiovascular, nutritional and nursing management is covered extensively. The physiotherapy, occupational therapy, orthotic management, sexuality and fertility and tetraplegic hand are described as a separate topic.
Section IV covers psychosocial management which includes the issues of psychosocial adjustment to SCI for family and individual. These are important in term of functional outcome of SCI patients. Peer counseling and psychotropic drug management are important to deal with psychiatric disorders, which may occur during the management of SCI patients.
In a long term of management of SCI various complications develop which are covered extensively in Section V. The pressure ulcer, musculoskeletal complications are discussed as pathology, prevention and treatment. The autonomic dysreflexia pain following SCI and the effect of spastical overall morbidity and mortality are included in this section. Section VI is devoted on predischarge planning and followup periodicity to suggest comprehensive continued care of SCI patient to prevent complications secondary to SCI on long term basis. The need and method of community inclusion are stressed as a separate topic. Certain specific issues such as late presentation of SCI patients, pediatric patients, geriatric patients, women with paraplegia and challenges in underdeveloped countries are discussed as a separate subheading. Section VIII is confined to the need, scope for experimental interventions to promote function recovery in SCI patients. The intervention strategies include preservation of intrinsic function, promoting regeneration, enhancing intrinsic function and pain management. The current stage of knowledge on cellular intervention in SCI is covered in this section. In the end, Section IX is devoted to the prevention of SCI which includes road traffic accident, fall, water accident, sports activities, fall of the load from a height, and nontraumatic SCI.
Summarily, this is a well-planned textbook on spinal cord injuries. The issues covered are extensive with a lucid description supported with tables and figures. It will be a useful book in the management of one of the most complex clinical problem. This can be used as a guide to the management of SCI.
I recommend this book as useful treatment guides in spinal units as well as Libraries of Medical Colleges where training is imparted.