History of the treatment of spinal injuries

Spinal cord injuries have been recognized since ancient times, but effective treatments are relatively modern. Historically, patients often died from complications like pressure sores and urinary tract infections. Modern treatment focuses on preventing complications, stabilizing the spine, and rehabilitating the patient toward independent living. Key figures in the development of spinal injury treatment include Theodor Kocher and Wilhelm Wagner in the 19th century, Donald Munro in the United States, and Ludwig Guttmann in the United Kingdom. Their work emphasized the importance of preventing secondary complications and early intervention. The First World War spurred the development of multidisciplinary spinal units in the UK, Germany and France, where surgeons, urologists and neurologists worked together, but high mortality was still reported. The modern era saw a shift in leadership to the US, where Donald Munro set up the first effective treatment center and Ludwig Guttmann established a specialized unit at Stoke Mandeville.

• 1
  Early management of spinal injuries focused on traction and laminectomy, but outcomes remained poor due to complications such as renal failure.
• 2
  Wilhelm Wagner emphasized practical treatment, including preventing pressure sores, managing bladder issues, and immobilizing patients until fractures healed.
• 3
  Ludwig Guttmann integrated various treatment ideas, emphasizing specialized units, early transfer of patients, and comprehensive therapeutic treatment, leading to improved outcomes.