St. Giles, St. Francis et al.: medical patron saints.
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Biomedical subjects
Publications and source records attributed to A Ohry.
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Since Sir Ludwig Guttmann introduced the comprehensive modern clinical approach to the rehabilitation of spinal cord injured patients much experience has been accumulated. Modern spinal cord injuries centres have opened throughout the world, treating mainly acute spinal cord injuries in young patients. At Stoke Mandeville Hospital we have had the opportunity to treat several spinal patients who had suffered previous neurological or orthopaedic disorders. These complicated combinations affected the rehabilitation process and the presentations show clearly different aspects of the problem.
Two cases of paraplegia caused by head injuries sustained in recent military conflicts are presented. The underlying pathological disturbances could be related to the CT scan appearances and are discussed in the light of previously reported series. Both cases were remarkable for an early and prolonged paraplegia which was flaccid, rather than spastic, and for the sensory impairment produced.
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Our experience with 17 patients with spinal cord injuries (SCI) acquired in the Lebanon War, 1982, is described. The SCI were due to gunshot wounds in 12 patients and to other causes in 5. Two laparotomies and one thoracotomy were performed. Corticosteroids were not seen to influence recovery, nor was laminectomy, which was performed in three cases. Complications such as pressure sores, hydronephrosis, ileus and deep vein thrombosis were rare or did not occur. Three high quadriplegics died. Based on our experience, we recommend conservative treatment and rehabilitation in acute SCI.
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Our hypothesis, based upon clinical observation and on the literature, is that chronic spinal cord injured patients are prone to premature aging. Physical and mental disabilities and prolonged immobilization change the entire homeostatic mechanisms into a new state. Thus, we feel that this lead to accelerated aging among these chronic handicapped persons.