Advances in Surgical Techniques and Instrumentation and Their Impact on the Spinal Cord Injury Rehabilitation Process

Injuries to the vertebral column may result in mechanical instability, neurologic compromise, or both. Historically, management has involved manipulative realignment of the osseous elements followed by immobilization. Immobilization of the spine may require the use of cumbersome braces, casts, skeletal traction, prolonged bed rest, or some combination therein. Such devices result in difficulties with patient transfers, delay in early mobilization and rehabilitation, prolongation of convalescence, and a negative psychological impact on the injured. Improvements in surgical techniques and spinal internal fixation systems have allowed for early and effective surgical stabilization of unstable injuries while minimizing the physiological insult to the injured. Such advances have allowed for a decreased reliance on external immobilization devices for spine immobilization, which facilitates early rehabilitation.